Individual
BREONTE NICOLE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3237 S 16TH ST, MILWAUKEE, WI 53215-4526
(414) 647-3995
Mailing address
4244 N 27TH ST APT 2, MILWAUKEE, WI 53216-1866
(414) 553-2862
Taxonomy
Speciality
Code
Description
License number
State
261QC0050X
Critical Access Hospital Clinic/Center
Primary
—
—
Other
Enumeration date
10/09/2023
Last updated
10/09/2023
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