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NPI Code Detail

MEDICARE: MARQUITA NOEL JOHNSON FNP

MEDICARE: MARQUITA NOEL JOHNSON FNP
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
1363LF0000XFamily Nurse Practitioner733810TX

General Provider Information

NPI Number : 1962730267
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARQUITA NOEL JOHNSON FNP
Provider Business Mailing Address
First Line : 13500 NOEL RD
Second Line : #526
City : DALLAS
State : TX
Zip : 75240-5049
Country : US
Telephone Number : 469-525-7554
Fax Number :
Provider Business Practice Location Address
First Line : 2591 FM 423
Second Line :
City : LITTLE ELM
State : TX
Zip : 75068-6664
Country : US
Telephone Number : 972-731-8032
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2009
Last Update Date : 01/19/2012

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