Meredith V Johnson, N.P.
Individual provider Active NPI Nurse Practitioner · Port Allen, LA
NPI 1083640908 · NPPES record last updated May 22, 2012
Key facts
- NPI
- 1083640908
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 29873 (LA)
- Practice address
- 751 Court St
Port Allen, LA 70767-2635 - Phone
- (225) 389-1311
- Fax
- (225) 389-1330
- NPI assigned
- Jun 23, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29873 | LA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Medicine, P.C. | Nurse Practitioner | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 29873 | LA | Yes |
Addresses
Primary practice location
751 Court St
Port Allen, LA 70767-2635
Mailing address
PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00376229 | Other | LA | METRAHEALTH RR |
| P00373288 | Other | LA | METRAHEALTH RR |
| 1183075 | Medicaid | LA |
Other providers in Port Allen, LA
- Hope Behavioral Health
- Heather C Huckaby
- Ronald E. Inkrott
- Matthew Fuller Irby
- Lakenya Johnson
- Treniece D Jones-Morrise
- Bryanna Immari Jones
- Lori Angelle Jones
- Tiffany Lea White Jones
- Just Health
All providers in Port Allen, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.