Healthcare Provider Details

I. General information

NPI: 1427675560
Provider Name (Legal Business Name): JONQUIL JOHNSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2020
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2911 BRUNSWICK RD
BARTLETT TN
38133-4105
US

IV. Provider business mailing address

1258 BREEZY VALLEY DR
CORDOVA TN
38018-6669
US

V. Phone/Fax

Practice location:
  • Phone: 901-377-4700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: