Johnson, Nicole Marie

Johnson, Nicole Marie is an individual health care provider with primary practice located at 11100 Euclid Avenue , Cleveland OH 44106. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Anesthesiology, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Johnson, Nicole Marie can be contacted via phone (216) 844-7700.

Contact Information

Primary practice address
11100 Euclid Avenue Cleveland OH 44106
Phone: (216) 844-7700
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Anesthesiology 207LP3000X 35-086941 Ohio
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 35086941 Ohio

Profile Details

NPI number 1710190947
LBN Legal business name Johnson, Nicole Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2007
Last updated Mar 14th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710190947 NPPES
Pennsylvania MEDICAID 1026733980001
Pennsylvania MEDICAID 2957870

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