Individual
MRS. KRISTA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
417 N MARTIN LUTHER KING DR, SIMMESPORT, LA 71369-2181
(800) 462-0742
(318) 941-2388
Mailing address
PO BOX 144, SIMMESPORT, LA 71369-0144
(800) 462-0742
(318) 941-2388
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
211416
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
12/23/2019
Last updated
01/14/2020
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