Provider Demographics
NPI:1629782396
Name:JOHNSON, ARIEL ESTELLE (CNM)
Entity type:Individual
Prefix:
First Name:ARIEL
Middle Name:ESTELLE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 HAVENSPORT DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45240-1813
Mailing Address - Country:US
Mailing Address - Phone:513-290-3236
Mailing Address - Fax:
Practice Address - Street 1:721 MIAMI CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4650
Practice Address - Country:US
Practice Address - Phone:937-281-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-09
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH465558163W00000X
OHAPRN.CNM.0019605367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse