Individual provider · Type 1 NPI
Antqualene Lavette Johnson, PA-C
Medical Physician Assistant · Fort Polk, LA
NPI number
1720346943
Active
Practice location
2260 Glory Loop, Bldg 1260
Fort Polk, LA 71446
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 1103343 |
Medical Physician Assistant: Definition to come...
Other medical physician assistant providers in Fort Polk
- Mitchell Brian Brooks, PAMedical Physician Assistant Fort Polk, LA NPI 1013003557
- Michael Davidson, PA-CMedical Physician Assistant Fort Polk, LA NPI 1255480018
- Jeffrey D. Olfert, PA-CMedical Physician Assistant Fort Polk, LA NPI 1700657855
- Nikki Micshawn Lewis, PAMedical Physician Assistant Fort Polk, LA NPI 1730241167
- Dennis Michael Sosenko, PA-CMedical Physician Assistant Fort Polk, LA NPI 1992765101
About NPI 1720346943
Antqualene Lavette Johnson, PA-C's National Provider Identifier is 1720346943, issued on Apr 25, 2012. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fort Polk, LA. The record was last updated on Apr 25, 2012.