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MRS. MILICENT CHERISSE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
2401 S 31ST ST, 4B PEDIATRIC GASTROENTEROLOGY CLINIC, TEMPLE, TX 76508-0001
(254) 724-2708
Mailing address
3821 OAK VALLEY DR, KILLEEN, TX 76542-4532
(254) 690-7452

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
634850
TX

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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