Johnson, Mary P.

Johnson, Mary P. is an individual health care provider with primary practice located at 2500 N State St , Jackson MS 39216-4500. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Johnson, Mary P. can be contacted via phone (601) 815-2005.

Contact Information

Primary practice address
2500 N State St Jackson MS 39216-4500
Phone: (601) 815-2005
Fax: (601) 703-9920
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X R864870 Mississippi

Profile Details

NPI number 1629050836
LBN Legal business name Johnson, Mary P.
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 15th, 2005
Last updated May 14th, 2021 - about 3 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 1629050836 NPPES
Other 430070545 RAILROAD MEDICARE
MEDICAID 00125198 RAILROAD MEDICARE

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