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NPI Code Detail

MEDICARE: KATOYA JOHNSON

MEDICARE:   KATOYA  JOHNSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP09134LA

General Provider Information

NPI Number : 1801334453
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATOYA JOHNSON
Provider Business Mailing Address
First Line : 1005 QUAIL CREEK RD APT A
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-2310
Country : US
Telephone Number : 318-230-3900
Fax Number :
Provider Business Practice Location Address
First Line : 1005 QUAIL CREEK RD APT A
Second Line :
City : SHREVEPORT
State : LA
Zip : 71105-2310
Country : US
Telephone Number : 318-230-3900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2017
Last Update Date : 02/03/2017

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Directions to “ KATOYA JOHNSON ” Practice Location

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