Provider Demographics
NPI:1720666480
Name:JOHNSON, JESSICA (AUD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:WHITFILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AUD
Mailing Address - Street 1:6650 W 110TH ST STE 330
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1798
Mailing Address - Country:US
Mailing Address - Phone:913-521-9090
Mailing Address - Fax:913-521-9955
Practice Address - Street 1:8640 N GREEN HILLS RD STE 43
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1903
Practice Address - Country:US
Practice Address - Phone:816-800-8020
Practice Address - Fax:816-800-8029
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
OK5603231H00000X
MO2024028466231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist