MS. Nicole A Johnson, PA-C

NPI #1033250576 in Carbondale, Illinois

Provider Information

NPI Number: 1033250576
Entity Type: Individual
Name: MS. Nicole A Johnson, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Feb 9, 2007
Last Updated: Nov 9, 2021

Practice Location

Address: 405 W JACKSON ST
City: Carbondale
State: Illinois
ZIP Code: 62901-1462
Phone: (618) 549-0721

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant - Medical — Medical	363AM0700X
Physician Assistant	363A00000X	Primary

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