Individual
NICOLE LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
3333 PONTCHARTRAIN DR, SLIDELL, LA 70458-4827
(985) 238-0320
(985) 238-0321
Mailing address
600 JEFFERSON ST STE 600, LAFAYETTE, LA 70501-6987
(337) 202-0720
(337) 465-4604
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R878829
MS
363LF0000X
Family Nurse Practitioner
Primary
237427
LA
363LF0000X
Family Nurse Practitioner
R878829
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05855337
—
MS
Enumeration date
01/05/2015
Last updated
10/22/2024
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