Individual
NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
398 NEPONSET AVE, DORCHESTER, MA 02122-3134
(617) 282-3200
Mailing address
12 DENNY ST, DORCHESTER, MA 02125-1041
(339) 225-2377
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN284060
MA
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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