Provider Demographics
NPI:1740044932
Name:JOHNSON-BENJAMIN, ERICA DANIELLE (PMHNP)
Entity type:Individual
Prefix:MRS
First Name:ERICA
Middle Name:DANIELLE
Last Name:JOHNSON-BENJAMIN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7795 HIGHWAY 107
Mailing Address - Street 2:
Mailing Address - City:MANSURA
Mailing Address - State:LA
Mailing Address - Zip Code:71350-4929
Mailing Address - Country:US
Mailing Address - Phone:318-308-8434
Mailing Address - Fax:318-310-1323
Practice Address - Street 1:213 E ETIENNE RD
Practice Address - Street 2:
Practice Address - City:MAURICE
Practice Address - State:LA
Practice Address - Zip Code:70555-4375
Practice Address - Country:US
Practice Address - Phone:318-308-8434
Practice Address - Fax:318-310-1323
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA208285363LP0808X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse