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Individual

MS. PATRICE JOHNELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP-BC

Contact information

Practice address
21610 PACIFIC HWY, OCEAN PARK, WA 98640-9864
(360) 665-3000
Mailing address
4468 CLIPPER CV, DESTIN, FL 32541-3699
(970) 371-7120
(850) 650-3774

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-128942
CO
163W00000X
Registered Nurse
RN-9246598
FL
363LF0000X
Family Nurse Practitioner
Primary
AP60697111
WA
363LF0000X
Family Nurse Practitioner
NP-10143
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
28528506
CO
Enumeration date
12/10/2009
Last updated
10/19/2020
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