Individual
MS. SHANNA MARIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
10625 W NORTH AVE STE 230, MILWAUKEE, WI 53226-2315
(414) 249-5698
(320) 207-5719
Mailing address
10625 W NORTH AVE STE 230, MILWAUKEE, WI 53226-2315
(414) 249-5698
(320) 207-5719
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
197266-30
WI
363LF0000X
Family Nurse Practitioner
Primary
14417-33
WI
Other
Enumeration date
02/04/2011
Last updated
05/28/2024
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