Individual
MICHELLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
404 PICASSO LN, CHARLESTON, SC 29492-7134
(423) 429-7306
Mailing address
404 PICASSO LN, CHARLESTON, SC 29492-7134
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
237047
TN
Other
Enumeration date
08/23/2021
Last updated
08/23/2021
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