Individual
MRS. HEATHER JOHNSON HARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.F.N.P.
Contact information
Practice address
138 CLINIC DRIVE, LIBERTY, MS 39645
(601) 657-8091
(601) 657-8873
Mailing address
3815A SMYLIE RD, LIBERTY, MS 39645-8249
(601) 657-1277
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R862562
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02323888
—
MS
Enumeration date
06/23/2006
Last updated
02/27/2008
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