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NPI Code Detail

MEDICARE: JILL CHRISTINE JOHNSON RN

MEDICARE: JILL CHRISTINE JOHNSON RN
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
1163W00000XRegistered NurseRN108997LA

General Provider Information

NPI Number : 1619811775
Entity Type Code : Individual
Provider Name (Legal Business Name) : JILL CHRISTINE JOHNSON RN
Provider Business Mailing Address
First Line : 39626 FLY CREEK RD
Second Line :
City : PONCHATOULA
State : LA
Zip : 70454-6820
Country : US
Telephone Number : 985-960-6917
Fax Number :
Provider Business Practice Location Address
First Line : 820 OAK HARBOR BLVD
Second Line :
City : SLIDELL
State : LA
Zip : 70458-8825
Country : US
Telephone Number : 985-707-2790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2026
Last Update Date : 04/17/2026

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