Healthcare Provider Details

I. General information

NPI: 1255088167
Provider Name (Legal Business Name): DONNA LAUREN JOHNSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 10/02/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1616 FATS DOMINO AVE
NEW ORLEANS LA
70117-2950
US

IV. Provider business mailing address

4143 SEMINARY PL
NEW ORLEANS LA
70126
US

V. Phone/Fax

Practice location:
  • Phone: 504-533-4999
  • Fax:
Mailing address:
  • Phone: 601-319-1837
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number905187
License Number StateMS
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number248664
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: