Individual
MRS. NICOLE LYNN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
8923 BLUEBONNET BLVD, BATON ROUGE, LA 70810-2814
(225) 766-4133
Mailing address
8923 BLUEBONNET BLVD, BATON ROUGE, LA 70810-2814
(225) 244-0836
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
228811
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2660004
—
LA
Enumeration date
12/23/2022
Last updated
07/25/2024
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