Provider Demographics
NPI:1427785849
Name:JOHNSON, TRINITY SHARDA' (FNP)
Entity type:Individual
Prefix:MRS
First Name:TRINITY
Middle Name:SHARDA'
Last Name:JOHNSON
Suffix:
Gender:
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MS
Mailing Address - Zip Code:39730-3336
Mailing Address - Country:US
Mailing Address - Phone:662-848-3656
Mailing Address - Fax:
Practice Address - Street 1:501 S CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MS
Practice Address - Zip Code:39730-3336
Practice Address - Country:US
Practice Address - Phone:662-369-6131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1841344892207R00000X
MS905289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine