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NPI Code Detail

MEDICARE: JENNIFER A. JOHNSEN ARNP

MEDICARE: JENNIFER A. JOHNSEN ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP30007261WA
2363LF0000XFamily Nurse PractitionerAP30007261WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10207591OTHERWAL&I PIN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
306621UOTHERWAREGENCE BLUE SHIELD PIN
461507UOTHERWAREGENCE BLUE SHIELD PIN

General Provider Information

NPI Number : 1063463891
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER A. JOHNSEN ARNP
Provider Business Mailing Address
First Line : 325 9TH AVE
Second Line : BOX 359911
City : SEATTLE
State : WA
Zip : 98104-2499
Country : US
Telephone Number : 206-744-3076
Fax Number : 206-744-2640
Provider Business Practice Location Address
First Line : 325 9TH AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98104-2499
Country : US
Telephone Number : 206-744-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2006
Last Update Date : 06/23/2011

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