Individual
CLAUDE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48267-0001
(952) 442-9770
Mailing address
DEPT 203401, PO BOX 67000, DETROIT, MI 48267-0001
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704229107
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ229107
BLUE CROSS OF MI
MI
Enumeration date
04/26/2006
Last updated
03/12/2008
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