Healthcare Provider Details

I. General information

NPI: 1275143463
Provider Name (Legal Business Name): JASMINE SHERRELL JOHNSON MSN, CNM, C-EFM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1225 E MARKET ST
YORK PA
17403-1250
US

IV. Provider business mailing address

6201 GREENLEIGH AVE
MIDDLE RIVER MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 717-845-9639
  • Fax: 717-699-1300
Mailing address:
  • Phone: 104-933-0000
  • Fax: 410-500-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WX0003X
TaxonomyInpatient Obstetric Registered Nurse
License NumberR217538
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberMW010590
License Number StatePA
# 3
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberR217538
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: