Individual
JO ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3220 W SILVER LAKE RD, FENTON, MI 48430-1374
(810) 750-1763
(810) 750-1786
Mailing address
3220 W SILVER LAKE RD, FENTON, MI 48430-1374
(810) 750-1763
(810) 750-1786
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
5101010026
MI
207Q00000X
Family Medicine Physician
5101010026
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4301746
—
MI
Enumeration date
07/24/2006
Last updated
09/11/2025
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