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NPI Code Detail

MEDICARE: NATALIE SUE JOHNSON RN, PHN, CSN

MEDICARE: NATALIE SUE JOHNSON RN, PHN, CSN
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
1163WS0200XSchool Registered Nurse95035678CA

General Provider Information

NPI Number : 1720546484
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATALIE SUE JOHNSON RN, PHN, CSN
Provider Business Mailing Address
First Line : 7089 LYNCH RD
Second Line :
City : SEBASTOPOL
State : CA
Zip : 95472-4462
Country : US
Telephone Number : 415-259-8197
Fax Number :
Provider Business Practice Location Address
First Line : 1000 YULUPA AVE
Second Line :
City : SANTA ROSA
State : CA
Zip : 95405-7020
Country : US
Telephone Number : 707-806-2570
Fax Number : 707-978-5945
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2019
Last Update Date : 03/12/2019

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