NPI 1003486556

Illisia Marie Johnston, NPC

Practitioner Family Nurse Practitioner Laurel, MS

Practice location

Address: 1008 N 15th Ave, Laurel, MS 39440-2656
Phone: (601) 426-5125
Mailing address: PO Box 247, Laurel, MS 39441-0247

Registered specialties

Family Nurse Practitioner Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363LF0000X Licence F06212134 (MS)

Other Nurse Practitioner providers in Mississippi →

Registry record

NPI: 1003486556
Entity type: Individual
Sex (as registered): Female
NPI issued: 28 Jun 2021
Record last updated: 3 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.