Individual
MRS. MATTIE B. JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
13599 VIRGIL ST, DETROIT, MI 48223-3050
(313) 535-6050
(313) 535-6050
Mailing address
13599 VIRGIL ST, DETROIT, MI 48223-3050
(313) 535-6050
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704224916
MI
Other
Enumeration date
08/23/2017
Last updated
08/23/2017
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