Healthcare Provider Details

I. General information

NPI: 1366636060
Provider Name (Legal Business Name): LULA MAE JOHNSON-FERRAND APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2007
Last Update Date: 12/05/2022
Certification Date: 12/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1691 BIENVILLE DR
MONROE LA
71201-3756
US

IV. Provider business mailing address

510 E STONER AVE
SHREVEPORT LA
71101-4243
US

V. Phone/Fax

Practice location:
  • Phone: 318-998-7850
  • Fax: 318-343-8600
Mailing address:
  • Phone: 318-221-8411
  • Fax: 318-343-8600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number828147
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR878132
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP05299
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: