Provider Demographics
NPI:1275143463
Name:JOHNSON, JASMINE SHERRELL (MSN, CNM, C-EFM)
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:SHERRELL
Last Name:JOHNSON
Suffix:
Gender:
Credentials:MSN, CNM, C-EFM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6201 GREENLEIGH AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLE RIVER
Mailing Address - State:MD
Mailing Address - Zip Code:21220-2004
Mailing Address - Country:US
Mailing Address - Phone:104-933-0000
Mailing Address - Fax:410-500-4266
Practice Address - Street 1:1225 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-1250
Practice Address - Country:US
Practice Address - Phone:717-845-9639
Practice Address - Fax:717-699-1300
Is Sole Proprietor?:No
Enumeration Date:2020-08-03
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR217538163WX0003X, 367A00000X
PAMW010590367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient