Nadine Irene Johnson, RN

Individual provider Active NPI Registered Nurse · Mohave Valley, AZ

NPI 1003108499 · NPPES record last updated May 4, 2011

Key facts

NPI
1003108499
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
710223 (CA)
Practice address
1607 Plantation Rd
Mohave Valley, AZ 86440-8420
Phone
(928) 346-4679
Fax
(928) 346-4686
NPI assigned
May 4, 2011
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN153520AZMDRegistered Nurse
710223CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 710223 CA Yes
Registered Nurse 163W00000X RN153520 AZ

Addresses

Primary practice location

1607 Plantation Rd
Mohave Valley, AZ 86440-8420

Mailing address

1607 Plantation Rd
Mohave Valley, AZ 86440-8420
Phone (928) 346-4679

Other providers in Mohave Valley, AZ

All providers in Mohave Valley, AZ · Registered Nurse in Arizona

Sources for this page

Verify at the official NPI Registry.