Individual
WANDA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCFNP
Contact information
Practice address
350 W WOODROW WILSON AVE, SUITE 411, JACKSON, MS 39213-7681
(601) 364-2666
Mailing address
350 W WOODROW WILSON AVE, SUITE 411, JACKSON, MS 39213-7681
(601) 364-2666
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R586986
MS
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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