Provider Demographics
NPI:1558656553
Name:WESTERFIELD, JOHNNIE AUSIE (FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:JOHNNIE
Middle Name:AUSIE
Last Name:WESTERFIELD
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 TREETOPS BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-7645
Mailing Address - Country:US
Mailing Address - Phone:601-939-1808
Mailing Address - Fax:601-939-3828
Practice Address - Street 1:1006 TREETOPS BLVD STE 102
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7645
Practice Address - Country:US
Practice Address - Phone:601-939-1808
Practice Address - Fax:601-939-3828
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR860226363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily