Individual
MRS. DEIDRE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1050 RIVER OAKS DR STE 100, FLOWOOD, MS 39232
(601) 200-4760
Mailing address
1050 RIVER OAKS DR STE 100, FLOWOOD, MS 39232-9564
(601) 200-4760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902787
MS
Other
Enumeration date
04/29/2019
Last updated
11/16/2019
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