Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Tanisha A Johnson-Jackson

Individual provider Adult Health Nurse Practitioner · NPI 1477218113

Mrs. Tanisha A Johnson-Jackson is an Adult Health Nurse Practitioner in Centerville, Ohio. Practices as a sole proprietor. Licensed in Ohio.

Licensed in
OH
In the registry since
2021
Specialties on file
3

Practice location Address checks out

7095 Clyo Rd
Centerville, OH 45459-4816
Phone: (937) 458-5084
Fax: (937) 458-5089
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN.CNP.026724 (OH)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence APRN.CNP.026724 (OH)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence APRN.CNP.062724 (OH)

Record details

NPI number1477218113
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 8, 2021
Last updated in NPPESNovember 16, 2021
Certification dateNovember 16, 2021

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