Individual
JESSICA PAIGE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 GENESYS PKWY STE 2432, GRAND BLANC, MI 48439-8065
(810) 606-5019
Mailing address
1 GENESYS PKWY STE 2432, GRAND BLANC, MI 48439-8065
(810) 606-5019
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704319822
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
135290
MI
Other
Enumeration date
07/06/2020
Last updated
09/13/2020
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