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Contact Information

JESSILYN M JOHANNSEN, RN
2720 STONE PARK BLVD
SIOUX CITY, IA51104-3734
 Phone: 712-279-3750
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Administrator

163WA2000X
Indicates primary specialty

NPI Profile & details for JESSILYN M JOHANNSEN · (Female)

NPI Number 1811731490
Status Active
Credentials RN (Registered Nurse)
Entity Individual
Enumeration date 06/19/2024
Last updated 04/28/2026 - About a month ago
Sole proprietor 1 No
Identifiers
  • IA License # 126879
  • IA License # A185562
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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