Individual
SHAKYLA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
272 CALHOUN STATION PARKWAY, SUITE C, MADISON, MS 39110
(662) 374-1598
Mailing address
3019 HIGHWAY 82 E APT 5D, GREENWOOD, MS 38930-6062
(662) 374-1598
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MS
Other
Enumeration date
07/30/2025
Last updated
07/30/2025
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