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ABBEY JOHNSON DICHIARA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
2323 5TH ST N, COLUMBUS, MS 39705-2213
(662) 368-1169
(662) 570-1492
Mailing address
2323 5TH ST N, COLUMBUS, MS 39705-2213
(662) 368-1169
(662) 570-1492

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R888625
MS
363LF0000X
Family Nurse Practitioner
20721
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
20721
APN -TN LICENSE
TN
Enumeration date
11/30/2015
Last updated
07/10/2019
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