Individual
NACOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1150 N ROOSEVELT DR APT 104, SEASIDE, OR 97138-7053
(503) 717-7150
Mailing address
1150 N ROOSEVELT DR APT 104, SEASIDE, OR 97138-7053
(503) 717-7150
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
201406840RN
OR
Other
Enumeration date
01/08/2021
Last updated
01/08/2021
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