Individual
CHARISSE LASHAUNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4105 HOSPITAL ST, PASCAGOULA, MS 39581-5312
(228) 762-8946
Mailing address
3993 COTTAGE HILL RD APT 19C, MOBILE, AL 36609-4230
(251) 423-4376
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1-120774
AL
363LF0000X
Family Nurse Practitioner
208338
LA
363LF0000X
Family Nurse Practitioner
Primary
903697
MS
Other
Enumeration date
08/19/2019
Last updated
05/02/2020
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