ILLISIA MARIE JOHNSTON

LAUREL, MS
NPI1003486556
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MS  F06212134)
Enumeration Date2021-06-28
Last Update Date2024-10-03
Business Address
ILLISIA MARIE JOHNSTON NP-C
1008 N 15TH AVE
LAUREL, MS 39440-2656
Phone number: 601-426-5125
Mailing Address
ILLISIA MARIE JOHNSTON NP-C
PO BOX 247
LAUREL, MS 39441-0247
Phone number:
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