Individual
DIANE S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
5000 HIGHWAY 39 N, MERIDIAN, MS 39301-1021
(601) 483-6211
Mailing address
5000 HIGHWAY 39 N, MERIDIAN, MS 39301-1021
(601) 483-6211
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
902815
MS
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
902815
MS
Other
Enumeration date
07/19/2018
Last updated
11/20/2019
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