Individual
MS. MARSHA ROCHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
400 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1014
(314) 362-4362
(314) 747-3338
Mailing address
660 S EUCLID AVE, C B 8072, SAINT LOUIS, MO 63110-1010
(314) 362-4362
(314) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2003020218
MO
363LA2100X
Acute Care Nurse Practitioner
2003020218
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1154595072
—
MO
05
—
ENROLLED
—
IL
Enumeration date
04/22/2008
Last updated
02/05/2018
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