Individual
MRS. KIMBERLY ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3601 W 13 MILE RD, PHYSICIAN EXTENDER, ROYAL OAK, MI 48073-6712
(248) 898-4021
(248) 898-1473
Mailing address
750 STEPHENSON HIGHWAY, WILLIAM BEAUMONT HOSPITAL PAYOR CONTRACT SERVICES, TROY, MI 48083-1103
(248) 577-3520
(248) 577-3526
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005757
MI
Other
Enumeration date
06/17/2010
Last updated
08/16/2011
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