Individual
ASHLEY NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 UNIVERSITY BLVD, TYLER, TX 75799-6600
(903) 565-5777
Mailing address
2011 BRENT ST, BOSSIER CITY, LA 71112-4107
(903) 426-5000
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
12/05/2025
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