Individual
MS. JOHANNA CLARA NESSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1620 E 12TH ST, THE DALLES, OR 97058-3213
(541) 296-9151
(541) 296-9156
Mailing address
PO BOX 1520, THE DALLES, OR 97058-1520
(541) 296-7668
(541) 296-6431
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
20120079NP
OR
363LF0000X
Family Nurse Practitioner
990369
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218103
—
OR
05
—
218112
—
OR
05
—
500632165
—
OR
Enumeration date
04/08/2012
Last updated
09/13/2012
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