Johnson, Jack Frank
Johnson, Jack Frank is an individual health care provider with primary practice located at 724 Arden Ln Suite 100, Rock Hill SC 29732-2996. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as his primary health care specialty. Johnson, Jack Frank can be contacted via phone (803) 980-7337.Contact Information
Primary practice address
724 Arden Ln Suite 100
Rock Hill SC 29732-2996
Phone: (803) 980-7337
Fax: (803) 980-2229
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 364SP0200X | 3360 | South Carolina |
Profile Details
| NPI number | 1962638999 |
|---|---|
| LBN Legal business name | Johnson, Jack Frank |
| Credentials | Advanced Practice Registered Nurse (APRN) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 4th, 2009 |
| Last updated | Jun 4th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962638999 | NPPES |
| South Carolina | Other | 3360 | SOUTH CAROLINA STATE LICENSE |
| South Carolina | Other | 54-03360 | SOUTH CAROLINA STATE LICENSE |
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