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Individual

MISS NIKIA NICOLE JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2103 BARIAL AVE, PASCAGOULA, MS 39567-3405
(251) 648-5727
(228) 471-5182
Mailing address
2103 BARIAL AVE, PASCAGOULA, MS 39567-3405
(251) 648-5727
(228) 471-5182

Taxonomy

Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
6475605
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6475605
DL
AL
Enumeration date
10/13/2021
Last updated
10/13/2021
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