Individual
STEPHANIE RAYNELL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2215 VETERANS BLVD, METAIRIE, LA 70072
(504) 838-3524
Mailing address
1943 BROOKTER ST, SLIDELL, LA 70461-4824
(504) 579-6980
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
203912
LA
Other
Enumeration date
04/12/2019
Last updated
04/12/2019
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