Nicholas Samuel Johnson, FNP Valid NPI

Individual provider · Family Medicine Physician · O Fallon, MO

NPI

1164309985

Type

Individual (Type 1)

Primary specialty

Family Medicine Physician (Family Medicine)

Specialty group

Allopathic & Osteopathic Physicians

Taxonomy code

207Q00000X

License number

2019006383 (MO)

Sex

Male

Sole proprietor

Yes

Enumerated

2025-08-21

Last updated

2025-08-21