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1073531091
PHYLLIS POLK JOHNSON
JACKSON, MS
NPI
1073531091
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MS R574848)
Enumeration Date
2006-07-17
Last Update Date
2007-07-08
Business Address
Ms. PHYLLIS POLK JOHNSON FNP
1500 E WOODROW WILSON AVE
JACKSON, MS 39216-5116
Phone number: 601-362-4471
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Mailing Address
Ms. PHYLLIS POLK JOHNSON FNP
1542 FAIRWOOD DR
JACKSON, MS 39213-7915
Phone number: 601-366-2768
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