MRS. Antqualene Lavette Johnson, PA-C

NPI #1720346943 in Fort Polk, Louisiana

Provider Information

NPI Number
1720346943
Entity Type
Individual
Name
MRS. Antqualene Lavette Johnson, PA-C
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Physician Assistant - Medical
Credential
PA-C
Enumeration Date
Apr 25, 2012
Last Updated
Apr 25, 2012

Practice Location

Address
2260 GLORY LOOP
Address 2
BLDG 1260
ZIP Code
71446
Phone
(337) 531-4127

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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