Individual
PAMELA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1423 FIELD ST, DETROIT, MI 48214-2321
(313) 924-7860
(313) 924-0350
Mailing address
1423 FIELD ST, DETROIT, MI 48214-2321
(313) 924-7860
(313) 924-0350
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704240040
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704240040
REGISTERED NURSE
MI
Enumeration date
12/21/2015
Last updated
12/21/2015
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