Individual
MR. ANDREW JOHNSON III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
2900 CONNER ST, DETROIT, MI 48215-2407
(313) 308-1408
(313) 824-5590
Mailing address
24240 MULBERRY DR, SOUTHFIELD, MI 48033-3117
(313) 623-3069
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
4704193600
MI
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
4704193600
MI
Other
Enumeration date
01/23/2014
Last updated
01/23/2014
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