Johnson, Martha J

Johnson, Martha J is an individual health care provider with primary practice located at 1220 Jefferson St , Laurel MS 39440-4355. 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, Martha J can be contacted via phone (601) 426-4507.

Contact Information

Primary practice address
1220 Jefferson St Laurel MS 39440-4355
Fax: (601) 426-4228
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R552992 Mississippi

Profile Details

NPI number 1700827250
LBN Legal business name Johnson, Martha J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 8th, 2006
Last updated Feb 11th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1700827250 NPPES
Mississippi MEDICAID 00114833

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