Nicole Ann Johnson, RP
Individual provider Active NPI Pharmacist · Cambridge, NE
NPI 1982220232 · NPPES record last updated Jun 23, 2020
Key facts
- NPI
- 1982220232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 11307 (NE)
- Practice address
- 624 Patterson St
Cambridge, NE 69022-6597 - Phone
- (308) 697-3400
- NPI assigned
- Jun 23, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11307 | NE | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poniday LLC | Past |
Accepting new patients | |
| Poniday LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 11307 | NE | Yes |
Addresses
Primary practice location
624 Patterson St
Cambridge, NE 69022-6597
Mailing address
624 Patterson St
Cambridge, NE 69022-6597
Phone (308) 697-3400
Other names
- Nicole Ann Estabrook
Other providers in Cambridge, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 23, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.