Individual
BIANCA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15162 FAUST AVE, DETROIT, MI 48223-2307
(313) 673-5892
Mailing address
9585 WARWICK ST, DETROIT, MI 48228-1322
(000) 000-0000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704357542
MI
164W00000X
Licensed Practical Nurse
4703111540
MI
Other
Enumeration date
08/11/2015
Last updated
07/25/2024
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