Organization
HOLLY JOHNSON LTC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOLLY M AUGUSTUS FNP-C (OWNER/EMPLOYEE)
(903) 721-0865
Entity
Organization
Contact information
Practice address
5505 NEW COPELAND RD, TYLER, TX 75703-3955
(903) 705-0202
Mailing address
608 MONROE ST, JACKSONVILLE, TX 75766-4342
(903) 721-0865
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
AP136353
TX
Other
Enumeration date
02/09/2018
Last updated
06/14/2019
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