Individual
MISS LAYNE BROUSSARD JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10374 HIGHWAY 165 N STE B, STERLINGTON, LA 71280-3320
(318) 665-4543
Mailing address
10374 HIGHWAY 165 N STE B, STERLINGTON, LA 71280-3320
(318) 665-4543
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
A10595RX
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1627747
—
LA
Enumeration date
06/26/2006
Last updated
06/26/2014
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