Individual
NICOLE RUNYAN-JOHANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1100 ANDRE ST STE 301, NEW IBERIA, LA 70563-2159
(337) 364-9225
Mailing address
1100 ANDRE ST STE 301, NEW IBERIA, LA 70563-2159
(337) 364-9225
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP10214
LA
Other
Enumeration date
11/04/2018
Last updated
11/04/2018
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