Individual
MS. COURTNEY K. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-9160
(414) 805-9170
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-9160
(414) 805-9170
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1583
WI
363AS0400X
Surgical Physician Assistant
Primary
1583
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053325126
—
WI
Enumeration date
07/27/2006
Last updated
03/17/2023
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