Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JAYDEN JACK JOHNSON
Active Sole ProprietorJAYDEN JACK JOHNSON is a Military Health Care Provider healthcare provider located in BROOKINGS, South Dakota. NPI 1679464119 is currently active in the NPPES registry. Verify at CMS.
Military Health Care Provider · BROOKINGS, SD
Registration Details
- NPI Number
- 1679464119
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 12, 2025 (1.1054570497789 yrs)
- Last Updated
- Jul 12, 2025
- Licenses
-
E3904089E3904089
- Sole Proprietor
- Yes
Practice Information
- Address
-
527 5TH AVE S APT F6BROOKINGS, SD, 570063340Browse SD providers · Browse ZIP 57006
- Phone
- 6059240521
- Primary Specialty
-
Military Health Care Provider
171000000X
- Additional Specialty
- Emergency Medical Technician, Basic
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.