Provider Demographics
NPI:1881224244
Name:SHINOZUKA-JOHNSON, NANCY SACHIE (AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:SACHIE
Last Name:SHINOZUKA-JOHNSON
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3259 CATLIN AVE
Mailing Address - Street 2:
Mailing Address - City:QUANTICO
Mailing Address - State:VA
Mailing Address - Zip Code:22134-5109
Mailing Address - Country:US
Mailing Address - Phone:703-784-1528
Mailing Address - Fax:703-784-1530
Practice Address - Street 1:3259 CATLIN AVE
Practice Address - Street 2:
Practice Address - City:QUANTICO
Practice Address - State:VA
Practice Address - Zip Code:22134-5109
Practice Address - Country:US
Practice Address - Phone:703-784-1528
Practice Address - Fax:703-784-1530
Is Sole Proprietor?:No
Enumeration Date:2020-01-24
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR186063363LA2200X, 363LX0106X
VA0024177640363LA2200X, 363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health