Individual
JOSEPHINE VICTORIA JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2317 TRADEWINDS DR, GAUTIER, MS 39553-7034
(228) 990-3166
Mailing address
2317 TRADEWINDS DR, GAUTIER, MS 39553-7034
(228) 990-3166
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P285528
MS
Other
Enumeration date
07/29/2007
Last updated
07/29/2007
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