Individual
NICOLE APRIL JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DEM
Contact information
Practice address
310 LELAND AVE, CANYONVILLE, OR 97417-9789
(541) 530-1821
Mailing address
310 LELAND AVE, CANYONVILLE, OR 97417-9789
(541) 530-1821
Taxonomy
Speciality
Code
Description
License number
State
175M00000X
Lay Midwife
Primary
—
—
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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