Individual
MS. GENEVIEVE TEKLA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, NP
Contact information
Practice address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 578-6111
Mailing address
10 PETERBORO ST, DETROIT, MI 48201-2722
(313) 578-6111
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
4704270299
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704270299
MI
Other
Enumeration date
02/17/2011
Last updated
04/15/2013
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