Provider Demographics
NPI:1902449010
Name:HJERSMAN EVERSON, JOHNNA MARIE (PLMHP)
Entity Type:Individual
Prefix:
First Name:JOHNNA
Middle Name:MARIE
Last Name:HJERSMAN EVERSON
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6338 LAFAYETTE AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68132-1255
Mailing Address - Country:US
Mailing Address - Phone:402-314-0981
Mailing Address - Fax:
Practice Address - Street 1:2126 N 117TH AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68164-3670
Practice Address - Country:US
Practice Address - Phone:402-934-1617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist