Individual
LEVI JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
830 S GLOSTER ST, TUPELO, MS 38801-4996
(662) 377-5705
Mailing address
4381 S EASON BLVD, TUPELO, MS 38801-4996
(662) 377-5700
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
906237
MS
Other
Enumeration date
08/31/2023
Last updated
09/09/2023
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