Individual
MISS DANIELLE L JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
99 MARKET CENTER DR, COLLIERVILLE, TN 38017-6913
(901) 861-9610
(901) 861-9611
Mailing address
99 MARKET CENTER DR, COLLIERVILLE, TN 38017-6913
(901) 861-9610
(901) 861-9611
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
10001421A
IN
363A00000X
Physician Assistant
Primary
2529
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03172746
—
MS
05
—
Q008791
—
TN
Enumeration date
07/18/2012
Last updated
07/22/2024
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