Individual
MICHELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1287 BURNS WAY, KALISPELL, MT 59901-3109
(406) 752-8120
Mailing address
1287 BURNS WAY, KALISPELL, MT 59901-3109
(406) 752-8120
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
36942
MT
363A00000X
Physician Assistant
8098517-1206
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01060441
PROVIDER IDENITIER
UT
Enumeration date
11/01/2011
Last updated
11/27/2023
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