Individual
NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8930 STANFORD BLVD STE M100, COLUMBIA, MD 21045-5805
(443) 285-0807
(443) 285-0527
Mailing address
8930 STANFORD BLVD STE M100, COLUMBIA, MD 21045-5805
(443) 285-0807
(443) 285-0527
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP48221
MD
Other
Enumeration date
04/08/2021
Last updated
04/08/2021
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