Individual
SHUNDRAKIA L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3603 W CONGRESS ST APT 101A, LAFAYETTE, LA 70506-5201
(337) 303-3699
Mailing address
PO BOX 61698, LAFAYETTE, LA 70596-1698
(337) 442-8878
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
256988
LA
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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