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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. JEREMY EZRA JOHNSON

Active Sole Proprietor

MR. JEREMY EZRA JOHNSON is a Athletic Trainer healthcare provider located in STATELINE, Nevada. NPI 1578197984 is currently active in the NPPES registry. Verify at CMS.

Athletic Trainer · STATELINE, NV

Registration Details

NPI Number
1578197984
Provider Type
Individual
Gender
Male
NPI Issued
Feb 24, 2020 (6.2944170688274 yrs)
Last Updated
Feb 24, 2020
Sole Proprietor
Yes

Practice Information

Address
331 TRAMWAY DR # 16
STATELINE, NV, 894499812
Browse NV providers · Browse ZIP 89449
Phone
8056103415
Primary Specialty
Athletic Trainer
2255A2300X

Other Athletic Trainer Providers in STATELINE, NV

Name Credential NPI
NATALIE STEVENSON 1962036376
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.