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Individual

MRS. PATSY JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
29 S FOURTH ST, ROLLING FORK, MS 39159-5146
(662) 873-4361
(662) 873-2921
Mailing address
PO BOX 520, ROLLING FORK, MS 39159-0520
(662) 873-4361
(662) 873-2921

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R559784
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118165
MS
Enumeration date
07/13/2006
Last updated
07/08/2007
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