Individual
MIRANDA C JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
281 W 4TH ST, INDEPENDENCE, LA 70443-2386
(985) 878-0066
(985) 878-0626
Mailing address
2057 WHITE MYRTLE DR, MADISONVILLE, LA 70447-9480
(985) 259-0822
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.A10528.RX
LA
Other
Enumeration date
06/10/2006
Last updated
01/30/2013
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