Individual
ESTELLE MARIE JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC, RN
Contact information
Practice address
161 FORT WASHINGTON AVE FL 9, NEW YORK, NY 10032-3729
(212) 305-0527
(212) 305-6891
Mailing address
630 W 168TH ST # 4, NEW YORK, NY 10032-3725
(212) 305-0527
(212) 305-6891
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
739695
NY
363LA2100X
Acute Care Nurse Practitioner
Primary
431506
NY
Other
Enumeration date
07/15/2019
Last updated
05/15/2025
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