Individual
MIKAELA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
509 MARGARET ST, COMBINED LOCKS, WI 54113-1312
(920) 843-1187
Mailing address
509 MARGARET ST., COMBINED LOCKS, WI 54113
(920) 843-1187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
199748
WI
163WH0200X
Home Health Registered Nurse
199748
WI
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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