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Individual

MRS. DIA M. JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, WHNP-BC, FNP-C

Contact information

Practice address
1525 FAIRFIELD AVE STE 569, SHREVEPORT, LA 71101-4331
(318) 676-7489
(318) 676-7560
Mailing address
1525 FAIRFIELD AVE STE 569, SHREVEPORT, LA 71101-4331
(318) 676-7489

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP07939
LA
363LW0102X
Women's Health Nurse Practitioner
Primary
AP07939
LA

Other

Enumeration date
02/27/2017
Last updated
07/24/2023
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