Basic Information
| Provider Information | |||||||||
| NPI: | 1275143463 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | JASMINE | ||||||||
| MiddleName: | SHERRELL | ||||||||
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| Credential: | MSN, CNM, C-EFM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1225 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174031250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178459639 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1225 E MARKET ST | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174031250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178459639 | ||||||||
| FaxNumber: | 7176991300 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2020 | ||||||||
| LastUpdateDate: | 08/16/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WX0003X | R217538 | MD | N | Nursing Service Providers | Registered Nurse | Obstetric, Inpatient | 367A00000X | R217538 | MD | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | MW010590 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.