Individual
NATHAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Mailing address
223860 ORCHID LN, WAUSAU, WI 54401-6629
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
WI
Other
Enumeration date
07/02/2022
Last updated
12/28/2024
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