Nicole Nyesha Johnson, LPN

Primary specialty

Licensed Psychiatric TechnicianTaxonomy code 167G00000X

License

PN295419 Issued in PA

Practice address

514 S 57TH St # a
Philadelphia, PA 19143-1928

Phone

(215) 617-5996

NPI assigned

Jul 27, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722038400000",
    "number": "1639908882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 S 57TH ST # A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431928",
            "telephone_number": "215-617-5996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 S 57TH ST # A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191431928",
            "telephone_number": "215-617-5996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "middle_name": "NYESHA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-07-27",
        "last_updated": "2024-07-27",
        "certification_date": "2024-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "167G00000X",
            "taxonomy_group": "",
            "desc": "Licensed Psychiatric Technician",
            "state": "PA",
            "license": "PN295419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael T Johnson
• Monica Johnson
• Nathan John Johnson, P.T.
• Natia Johnson
• Nicole Gabbrielle Johnson, PH.D, LPC, CAADC
• Nicolette Michele Johnson, MD, PHD
• Norman L Johnson
• Patrick M Johnson
• Paul B Johnson, MD
• Paul Colonius Johnson IV, M.D.

• Licensed Psychiatric Technician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Licensed Psychiatric Technician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.