Individual
DANIEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
145 MICHIGAN ST NE STE 3410, GRAND RAPIDS, MI 49503-2563
(616) 391-9945
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704302932
MI
Other
Enumeration date
11/03/2017
Last updated
02/17/2021
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