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Individual

MEREDITH V JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
N.P.

Contact information

Practice address
751 COURT ST, PORT ALLEN, LA 70767-2635
(225) 389-1311
(225) 389-1330
Mailing address
PO BOX 395, CLINTON, LA 70722-0395
(225) 683-5292
(225) 683-3411

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
29873
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1183075
LA
01
P00373288
METRAHEALTH RR
LA
01
P00376229
METRAHEALTH RR
LA
Enumeration date
06/23/2006
Last updated
05/22/2012
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