Individual provider · Type 1 NPI

Illisia Marie Johnston, NP-C

Family Nurse Practitioner · Laurel, MS

NPI number 1003486556 Active

Practice location

1008 N 15th Ave
Laurel, MS 39440-2656

Mailing address

PO Box 247
Laurel, MS 39441-0247

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000XF06212134 (MS)

Family Nurse Practitioner: Definition to come...

10 other providers at this address

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About NPI 1003486556

Illisia Marie Johnston, NP-C's National Provider Identifier is 1003486556, issued on Jun 28, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Laurel, MS. The record was last updated on Oct 3, 2024.