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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MRS. ANTQUALENE LAVETTE JOHNSON, PA-C

Active

Medical Physician Assistant · FORT POLK, LA

Registration Details

NPI Number
1720346943
Provider Type
Individual
Gender
Female
NPI Issued
Apr 25, 2012 (13.99196486914 yrs)
Last Updated
Apr 25, 2012
License
1103343

Practice Information

Address
2260 GLORY LOOP
BLDG 1260
FORT POLK, LA, 71446
Browse LA providers · Browse ZIP 71446
Phone
3375314127
Primary Specialty
Medical Physician Assistant
363AM0700X

Other Medical Physician Assistant Providers in FORT POLK, LA

Name Credential NPI
MR. DENNIS MICHAEL SOSENKO PA-C 1992765101
NIKKI MICSHAWN LEWIS PA 1730241167
MICHAEL DAVIDSON PA-C 1255480018
KELLY J MARCOUX P.A.-C 1477687952
JEFFREY D OLFERT PA-C 1700657855
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.