Provider Demographics
NPI:1083400535
Name:JOHNSON, JANET NICOLE (PMHNP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:NICOLE
Last Name:JOHNSON
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1737 QUINCY ST
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-1637
Mailing Address - Country:US
Mailing Address - Phone:732-917-5918
Mailing Address - Fax:
Practice Address - Street 1:1900 RARITAN RD
Practice Address - Street 2:
Practice Address - City:SCOTCH PLAINS
Practice Address - State:NJ
Practice Address - Zip Code:07076-2963
Practice Address - Country:US
Practice Address - Phone:908-889-7780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15307900363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health