Individual
TIMIKA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
26580 BERG RD, APT 1412, SOUTHFIELD, MI 48033-8601
(313) 240-2969
Mailing address
26580 BERG RD, APT 1412, SOUTHFIELD, MI 48033-8601
(313) 240-2969
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703114622
MI
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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