Individual
MS. SHANNON MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 234-7521
Mailing address
152 HIGHWAY 7 S, OXFORD, MS 38655-5392
(662) 234-7521
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
337432
MS
251S00000X
Community/Behavioral Health Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
337432
LPN LICENSE NUMBER
MS
Enumeration date
05/04/2022
Last updated
05/04/2022
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