MISS Nicole Marie Johnson, PA-C

NPI #1033414248 in Midvale, Utah

Provider Information

NPI Number: 1033414248
Entity Type: Individual
Name: MISS Nicole Marie Johnson, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 19, 2011
Last Updated: Jun 23, 2020

Practice Location

Address: 7302 S BINGHAM JUNCTION BLVD
City: Midvale
State: Utah
ZIP Code: 84047-4804
Phone: (801) 442-5502

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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