Nicole A Johnson in Carbondale - Physician Assistant
Nicole A Johnson - NPI 1033250576
Nicole A Johnson is a Physician Assistant in Carbondale, Illinois. Nicole A Johnson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Nicole A Johnson is 1033250576. The last update date is 2021-11-09.
Nicole A Johnson's current location address is 405 W Jackson St, Carbondale, Illinois. You can contact this provider via phone number 6185490721. The mailing address for Nicole A Johnson is 405 W Jackson St, Carbondale, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Nicole A Johnson |
|---|---|
| Address | 405 W Jackson St, Carbondale, Illinois |
| Phone Number | 6185490721 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1033250576 |
|---|---|
| Provider Enumeration Date | 2007-02-09 |
| Last Updated Date | 2021-11-09 |
Provider Mailing Address Detail
| Address | 405 W Jackson St |
|---|---|
| City | Carbondale |
| State | Illinois (IL) |
| Post Code | 629011462 |
| Phone Number | 6185490721 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 085-002903 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 085-002903 | IL | PA LICENSE NUMBER |
Post Comment/ Review Below
What is the unique identifier code issued to Nicole A Johnson by the Centers for Medicare & Medicaid Services?
The Nicole A Johnson has been assigned the NPI (National Provider Identifier) 1033250576. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Nicole A Johnson?
The Nicole A Johnson is situated at 405 W Jackson St, in the city of Carbondale, state of IL, with the zip code 629011462.
What is the Nicole A Johnson's specialty and taxonomy code?
The Nicole A Johnson's specialty is Physician Assistant, and the corresponding taxonomy code is 363A00000X.
When was the Nicole A Johnson's 1033250576 issued?
The Nicole A Johnson's 1033250576 was issued on 2007-02-09.
When was the information related to Nicole A Johnson most recently updated or refreshed?
The details pertaining to the Nicole A Johnson, including its address, specialty, and other relevant information, were last updated or refreshed on 2021-11-09.