MEDICARE: JEANANNE JOHNSON APRN-BC, FNP , PMHNP

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	6670082-4405	UT
2	363LF0000X	Family Nurse Practitioner	6670082-4405	UT

General Provider Information

NPI Number	:	1699928754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEANANNE JOHNSON APRN-BC, FNP , PMHNP

Provider Business Mailing Address
First Line	:	1358 S RIVER RIDGE LN
Second Line	:
City	:	SPANISH FORK
State	:	UT
Zip	:	84660-4610
Country	:	US
Telephone Number	:	180-166-9342
Fax Number	:

Provider Business Practice Location Address
First Line	:	1358 S RIVER RIDGE LN
Second Line	:
City	:	SPANISH FORK
State	:	UT
Zip	:	84660-4610
Country	:	US
Telephone Number	:	801-669-3425
Fax Number	:

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

Provider Enumeration Date	:	11/02/2008
Last Update Date	:	11/13/2024

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