Individual
MRS. TIFFANY SHANDREA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C, PMHNP-BC
Contact information
Practice address
17200 E 10 MILE RD, EASTPOINTE, MI 48021-3355
(313) 731-2719
(336) 654-0824
Mailing address
11305 PIERSON ST, DETROIT, MI 48228-1247
(248) 798-7820
(336) 654-0824
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
4704282282
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704282282
MI
Other
Enumeration date
03/17/2015
Last updated
09/05/2023
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