Individual
MRS. GRACE LOUISE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 805-8623
(414) 805-8641
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1700
(414) 955-0072
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8275
WI
363LF0000X
Family Nurse Practitioner
8275-33
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100075675
—
WI
Enumeration date
03/09/2018
Last updated
04/26/2024
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