Individual
MRS. MICHELE DAWN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
3775 N MULFORD RD, ROCKFORD, IL 61114-5632
(815) 636-6400
Mailing address
8870 POLARIS DR, MACHESNEY PARK, IL 61115-2258
(815) 877-1340
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
209.006878
IL
Other
Enumeration date
12/17/2007
Last updated
11/17/2021
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