Johnson, Elmina
Johnson, Elmina is an individual health care provider with primary practice located at 3502 W Northside Dr , Jackson MS 39213-4454. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Elmina can be contacted via phone (601) 362-5321.Contact Information
Primary practice address
3502 W Northside Dr
Jackson MS 39213-4454
Phone: (601) 362-5321
Fax: (601) 364-2600
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R133690 | Mississippi |
Profile Details
| NPI number | 1891736260 |
|---|---|
| LBN Legal business name | Johnson, Elmina |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 9th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891736260 | NPPES |
| Mississippi | MEDICAID | 00115564 |
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