Provider Demographics
NPI:1629782396
Name:JOHNSON, ARIEL ESTELLE (RN)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:ESTELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5493 BERMUDA BAY DR APT 2C
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-7101
Mailing Address - Country:US
Mailing Address - Phone:513-290-3236
Mailing Address - Fax:
Practice Address - Street 1:5493 BERMUDA BAY DR APT 2C
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43235-7101
Practice Address - Country:US
Practice Address - Phone:513-290-3236
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH465558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse