Individual
LEE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(586) 242-8187
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(586) 242-8187
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
4704218859
MI
Other
Enumeration date
04/17/2013
Last updated
04/17/2013
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