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Individual

MRS. TERRAN HALE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MN, FNP-C

Contact information

Practice address
1101 MEDICAL CENTER BLVD., MARRERO, LA 70072
(504) 256-8017
Mailing address
1101 MEDICAL CENTER BLVD, MARRERO, LA 70072-3147
(504) 256-8017

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08310
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
09335859
MS
05
2398989
LA
Enumeration date
06/26/2015
Last updated
10/28/2016
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