IndividualActive
Alicon Johnson, CPNP-AC
NPI 1265796981 · Critical Care Pediatric Nurse Practitioner · Jackson, MS
Provider details
- NPI number
- 1265796981
- Entity type
- Individual
- Primary specialty
- Critical Care Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-AC
- Sex
- Female
- Sole proprietor
- No
- License
- R862571 (MS)
Practice location
2500 N State St
Jackson, MS 39216-4500
Phone: (601) 214-9206
Fax: (601) 984-4214
Mailing address
2500 N State St
Jackson, MS 39216-4500
Registry dates
- Enumerated
- 2012-06-27
- Last updated
- 2012-06-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.