MEDICARE: MJM BY NACOLE LLC

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	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1952254930
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MJM BY NACOLE LLC

Provider Business Mailing Address
First Line	:	1807 SHERWOOD AVE
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-3526
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1807 SHERWOOD AVE
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71201-3526
Country	:	US
Telephone Number	:	318-451-2040
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LATOYA JOHNSON
Credential	:
Telephone Number	:	318-451-2040

Provider Enumeration Date	:	02/18/2026
Last Update Date	:	02/18/2026

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Directions to “MJM BY NACOLE LLC ” Practice Location

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