MEDICARE: JENNIFER LYNNE JOHNSON AAHCC

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
1	174H00000X	Health Educator

General Provider Information

NPI Number	:	1255777165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER LYNNE JOHNSON AAHCC

Provider Business Mailing Address
First Line	:	6303 WOODTHRUSH DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-1322
Country	:	US
Telephone Number	:	260-750-0506
Fax Number	:

Provider Business Practice Location Address
First Line	:	6303 WOODTHRUSH DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46835-1322
Country	:	US
Telephone Number	:	260-750-0506
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2013
Last Update Date	:	05/18/2013

Similar Medicare Providers

1447321831 — RITE AID OF MAINE INC
Practice Location Address:

84 EAST MAIN STREET
FORT KENT, ME
04743-1322

Practice Phone: 207-834-5444
Practice Fax:

1235285610 — MRS. TARA MICHELE CREWS MS OTRL
Practice Location Address:

1049 CHENA RD APT 9
FORT WAINWRIGHT, AK
99703-1322

Practice Phone: 907-356-1319
Practice Fax:

1003164583 — MRS. CHRISTIE SKINNER FREEMAN
Practice Location Address:

84 E MAIN ST
FORT KENT, ME
04743-1322

Practice Phone: 207-834-5444
Practice Fax:

1619329489 — DARRION GRANT COTA/L
Practice Location Address:

6105 PORTICO DR APT 1322
FORT WORTH, TX
76132-4181

Practice Phone: 407-437-9141
Practice Fax:

1750806014 — WALGREEN CO
Practice Location Address:

84 E MAIN ST
FORT KENT, ME
04743-1322

Practice Phone: 207-834-5444
Practice Fax: 207-834-2897

1487362901 — JOSE LUIS RIOS MT
Practice Location Address:

537 W KELLIS ST
FORT WORTH, TX
76115-1322

Practice Phone: 817-443-4687
Practice Fax:

Directions to “ JENNIFER LYNNE JOHNSON AAHCC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.