Individual
MRS. MORITHA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14175 REV. J. WHITE RD, INDEPENDENCE, LA 70443
(985) 510-5053
Mailing address
PO BOX 755, 14175 REV.J. WHITE RD, INDEPENDENCE, LA 70443-0755
(985) 510-5053
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
291266
LA
Other
Enumeration date
11/13/2013
Last updated
11/13/2013
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