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General NPI Number Information
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NPI Number | 1548629348
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Entity Type | Individual
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Provider Name | NICOLE LYNNE JOHNSON MSN, APRN, FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/22/2016
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Last Update Date | 11/25/2025
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Provider Practice Location Address
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Address Line | 2420 S UNION AVE STE 230
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City | TACOMA
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State | WA
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Zip | 98405-1323
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Country | US
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Telephone | 253-343-0915
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Fax |
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Provider Business Mailing Address
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Address Line | 3824 CEDAR SPRINGS RD STE 80114364
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City | DALLAS
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State | TX
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Zip | 75219-4136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61302316
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP131949
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License Number State | TX
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