Individual provider · Type 1 NPI
Mackenzie Johnson
Student in an Organized Health Care Education/Training Program · Deridder, LA
NPI number
1205792322
Active
Practice location
111 N Royal St
Deridder, LA 70634-3851
Fax (337) 222-4013
Mailing address
PO Box 642
Dry Creek, LA 70637-0642
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
2 other providers at this address
About NPI 1205792322
Mackenzie Johnson's National Provider Identifier is 1205792322, issued on Jan 2, 2026. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Deridder, LA. The record was last updated on Jan 2, 2026.