Individual
DR. NICOLE MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
11100 EUCLID AVENUE, CLEVELAND, OH 44106
(216) 844-7700
Mailing address
24701 EUCLID AVENUE, 3RD FLOOR, EUCLID, OH 44117
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
35-086941
OH
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
35086941
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026733980001
—
PA
05
—
2957870
—
OH
Enumeration date
05/07/2007
Last updated
03/14/2012
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