Individual
BRANDI DAVIS JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1200 NORTH STATE STREET, SUITE 420, JACKSON, MS 39202
(601) 355-3353
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 227-3255
(901) 227-3205
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
902163
MS
363LG0600X
Gerontology Nurse Practitioner
902163
MS
363LP2300X
Primary Care Nurse Practitioner
902163
MS
Other
Enumeration date
08/22/2017
Last updated
03/17/2018
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