Healthcare Provider Details

I. General information

NPI: 1760911044
Provider Name (Legal Business Name): JENNIFER ELIZABETH JOHNSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER ELIZABETH MORSE RN, CATC-3N

II. Dates (important events)

Enumeration Date: 06/08/2017
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

759 E HOLLAND AVE STE 101
SPOKANE WA
99218-1257
US

IV. Provider business mailing address

759 E HOLLAND AVE STE 101
SPOKANE WA
99218-1257
US

V. Phone/Fax

Practice location:
  • Phone: 509-270-0065
  • Fax: 509-319-2520
Mailing address:
  • Phone: 509-270-0065
  • Fax: 509-319-2520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95023410
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1911966
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number719740
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF11220446
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: