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Contact Information

ANTQUALENE L JOHNSON, PA-C
2260 GLORY LOOP
BLDG 1260
FORT POLK, LA71446
 Phone: 337-531-4127
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical

363AM0700X 97 Physician Assistant
Indicates primary specialty

NPI Profile & details for ANTQUALENE L JOHNSON · (Female)

NPI # 1720346943
Status Active
Credentials PA-C (Physician Assistant-Certified)
Entity Individual
Enumeration date 04/25/2012
Last updated 04/25/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • License # 1103343
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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