Individual
MISS TIFFANY RECHANDRA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, WHNP-BC
Contact information
Practice address
3577 W 13 MILE RD, ROYAL OAK, MI 48073-6710
(248) 551-1330
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
(248) 353-3078
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704248817
MI
363LW0102X
Women's Health Nurse Practitioner
4704248817
MI
Other
Enumeration date
06/16/2012
Last updated
01/27/2021
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