Individual
MRS. NICHOLE JOHNSON PRESTWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
106 WESTSIDE DR, DOTHAN, AL 36303-1908
(877) 231-3376
(850) 522-8354
Mailing address
2505 HARRISON AVE, PANAMA CITY, FL 32405-4464
(850) 233-3376
(850) 522-8354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-141456
AL
363LF0000X
Family Nurse Practitioner
Primary
1-141456
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-141456
STATE LICENSE
AL
01
—
F06180238
AANP BOARD CERTIFICATION
—
Enumeration date
06/19/2018
Last updated
03/04/2026
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