Individual
DR. KRISTEN JOHANNESSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
5450 FORT ST, TRENTON, MI 48183-4601
(734) 671-3297
Mailing address
400 GETTYSBURG RD UNIT 103, CANTON, MI 48187-6713
(707) 315-0987
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101023617
MI
Other
Enumeration date
03/03/2015
Last updated
07/21/2022
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