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General NPI Number Information
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NPI Number | 1619811775
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Entity Type | Individual
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Provider Name | JILL CHRISTINE JOHNSON RN
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Gender | Female
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Dates
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Enumeration Date | 04/17/2026
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 820 OAK HARBOR BLVD
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City | SLIDELL
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State | LA
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Zip | 70458-8825
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Country | US
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Telephone | 985-707-2790
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Fax |
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Provider Business Mailing Address
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Address Line | 39626 FLY CREEK RD
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City | PONCHATOULA
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State | LA
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Zip | 70454-6820
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Country | US
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Telephone | 985-960-6917
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN108997
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License Number State | LA
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