1194101709 NPI number — MRS. NAI M JOHNSON MS

Table of content: MRS. NAI M JOHNSON MS (NPI 1194101709)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194101709 NPI number — MRS. NAI M JOHNSON MS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
NAI
Provider Middle Name:
M
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194101709
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 S BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW ORLEANS
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70119-6447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-864-6234
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
294 WRIGHT AVE
Provider Second Line Business Practice Location Address:
APT 153
Provider Business Practice Location Address City Name:
TERRYTOWN
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70056-2620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-864-6234
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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