MEDICARE: SHEMEELA GAIL 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CIT-6003	LA
2	163WP0809X	Adult Psychiatric/Mental Health Registered Nurse	RN141382	LA
3	363LF0000X	Family Nurse Practitioner	245066	LA

General Provider Information

NPI Number	:	1619688637
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEMEELA GAIL JOHNSON

Provider Business Mailing Address
First Line	:	8040 STONESHIRE DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70818-5762
Country	:	US
Telephone Number	:	225-223-0365
Fax Number	:

Provider Business Practice Location Address
First Line	:	7485 OAKLEAF DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-3728
Country	:	US
Telephone Number	:	225-930-5056
Fax Number	:	225-930-5162

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2022
Last Update Date	:	05/23/2026

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Directions to “ SHEMEELA GAIL JOHNSON ” Practice Location

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