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NPI Code Detail

MEDICARE: MRS. ASHLEY NICOLE JOHNSON RN

MEDICARE:  MRS. ASHLEY NICOLE JOHNSON  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse2015006852MO

General Provider Information

NPI Number : 1710556048
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ASHLEY NICOLE JOHNSON RN
Provider Business Mailing Address
First Line : 3424 SABOURIN DR APT A
Second Line :
City : SAINT ANN
State : MO
Zip : 63074-3345
Country : US
Telephone Number : 314-225-4999
Fax Number :
Provider Business Practice Location Address
First Line : 3424 SABOURIN DR APT A
Second Line :
City : SAINT ANN
State : MO
Zip : 63074-3345
Country : US
Telephone Number : 314-225-4999
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2021
Last Update Date : 06/21/2021

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Directions to “ MRS. ASHLEY NICOLE JOHNSON RN” Practice Location

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