Individual
MRS. KIMBERLY MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
24 FRANK LLOYD WRIGHT DR, ANN ARBOR, MI 48105-9484
(734) 998-6022
(734) 998-9139
Mailing address
3621 SOUTH STATE STREET, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704207635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4830324-10
—
MI
01
—
5008657390
BCBS
MI
Enumeration date
02/09/2006
Last updated
11/25/2013
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