IndividualActive
Nicole Johnson, LPN
NPI 1639908882 · Licensed Psychiatric Technician · Philadelphia, PA
Provider details
- NPI number
- 1639908882
- Entity type
- Individual
- Primary specialty
- Licensed Psychiatric TechnicianNursing Service Providers
- Credential
- LPN
- Sex
- Female
- Sole proprietor
- Yes
- License
- PN295419 (PA)
Specialties & taxonomies
Nursing Service Providers
Practice location
514 S 57th St # a
Philadelphia, PA 19143-1928
Phone: (215) 617-5996
Approximate (ZIP-level) locationGet directions
Mailing address
514 S 57th St # a
Philadelphia, PA 19143-1928
Registry dates
- Enumerated
- 2024-07-27
- Last updated
- 2024-07-27
- Certified
- 2024-07-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.