Provider Demographics
NPI:1992949028
Name:JOHNSON-NOBLE, ERIN ELIZABETH (MS)
Entity type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELIZABETH
Last Name:JOHNSON-NOBLE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:912 N MEMORIAL DR
Mailing Address - Street 2:PO BOX 710
Mailing Address - City:MERRILL
Mailing Address - State:WI
Mailing Address - Zip Code:54452-3164
Mailing Address - Country:US
Mailing Address - Phone:715-539-2510
Mailing Address - Fax:715-536-6146
Practice Address - Street 1:304 KAPHAEM RD
Practice Address - Street 2:
Practice Address - City:TOMAHAWK
Practice Address - State:WI
Practice Address - Zip Code:54487-7800
Practice Address - Country:US
Practice Address - Phone:715-453-2141
Practice Address - Fax:715-459-7519
Is Sole Proprietor?:No
Enumeration Date:2009-04-20
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3117154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI42595500Medicaid