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Individual

MS. KATHLEEN JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
208 MAPLE ST.,, APT. 208, BIG RAPIDS, MI 49307
(231) 796-8594
Mailing address
208 MAPLE ST APT 209, BIG RAPIDS, MI 49307-1885
(231) 796-8594

Taxonomy

Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
4704134887
MI

Other

Enumeration date
04/13/2010
Last updated
04/13/2010
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