Individual
MARY ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
120 STONE CREEK BLVD STE 200, FLOWOOD, MS 39232-8210
(601) 822-2294
(601) 793-4273
Mailing address
1008 SHILOH RUN DR, CRYSTAL SPRINGS, MS 39059-8758
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
918717
MS
363LW0102X
Women's Health Nurse Practitioner
Primary
906992
MS
Other
Enumeration date
01/24/2023
Last updated
10/21/2024
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