Individual
NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
(314) 977-2570
Mailing address
3437 CAROLINE ST, SAINT LOUIS, MO 63104-1111
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/17/2026
Last updated
02/17/2026
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