Individual
CANDACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
62 OLD AIRPORT RD, HATTIESBURG, MS 39401-8382
(601) 544-4550
(601) 582-3373
Mailing address
252 PENNY LN, BRANDON, MS 39042-7558
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
902209
MS
Other
Enumeration date
01/25/2018
Last updated
09/26/2018
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