Individual
MS. REGINA RENEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4301 ORCHARD LAKE RD STE 180, WEST BLOOMFIELD, MI 48323-1684
(313) 492-5807
Mailing address
4301 ORCHARD LAKE RD STE 180, WEST BLOOMFIELD, MI 48323-1684
(313) 492-5807
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704236041
MI
Other
Enumeration date
06/27/2013
Last updated
10/26/2017
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