Individual
NICOLLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
1546 ULUPII ST, KAILUA, HI 96734-4443
(502) 262-1668
Mailing address
1546 ULUPII ST, KAILUA, HI 96734-4443
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
AT-223
HI
Other
Enumeration date
05/04/2015
Last updated
05/04/2015
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