Provider Demographics
NPI:1316378805
Name:JOHNSON, STEPHANIE GREER (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:GREER
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MRS
Other - First Name:STEPHANIE
Other - Middle Name:ANN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-C
Mailing Address - Street 1:216 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2415
Mailing Address - Country:US
Mailing Address - Phone:318-322-6411
Mailing Address - Fax:
Practice Address - Street 1:210 LAYTON AVE.
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:323-640-5104
Practice Address - Fax:318-325-8232
Is Sole Proprietor?:No
Enumeration Date:2013-12-09
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP07586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily