Individual ProviderJessica JohnsonSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124(402) 330-3211PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Johnson does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records today at 11:02 AM.Profile DetailsProvider ID1225375355Provider TypeIndividualFull NameJohnson, JessicaCredentialSLPGenderFemaleSole ProprietorNoEnumeration Date1/9/2013Last Updated1/9/2013Contact InformationPractice LocationPractice Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124Phone(402) 330-3211Fax(402) 330-5970Mailing LocationMailing Address13336 Industrial Rd, Suite 105, Omaha, NE 68137-1124Phone(402) 330-3211Fax(402) 330-5970Provider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense1519NebraskaProvider IdentifiersIDDescriptionIssuerIDPENDINGDescriptionMedicaidIssuerUnlistedNebraska