Individual
GLENDA EVON JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
30671 STEPHENSON HWY, MADISON HEIGHTS, MI 48071-1651
(248) 275-6373
Mailing address
23075 NORMANDY AVE, EASTPOINTE, MI 48021-1855
(586) 328-4106
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703118900
MI
Other
Enumeration date
04/15/2025
Last updated
04/15/2025
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