Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 0101269113 | VA |
NPI | 1033573118 |
---|---|
Provider Name | Jessica Marie Johns |
First Address | Charlottesville, VA 22908 |
Second Address | Charlottesville, VA 22903-3363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 24/06/2021 |