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Individual

NATHANIEL JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PMHNP-BC

Contact information

Practice address
2613 W HENRIETTA RD STE F, ROCHESTER, NY 14623-2327
(585) 702-2612
Mailing address
23 BATEAU TER, ROCHESTER, NY 14617-1201
(585) 703-2612

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
758875
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404969
NY

Other

Enumeration date
04/19/2023
Last updated
03/19/2024
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