Individual
ANDREA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, NP-C
Contact information
Practice address
7440 CLAREMONT ST, CANTON, MI 48187-1535
(313) 610-0238
Mailing address
7440 CLAREMONT ST, CANTON, MI 48187-1535
(313) 610-0238
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704264469
MI
363LG0600X
Gerontology Nurse Practitioner
4704264469
MI
Other
Enumeration date
02/13/2015
Last updated
02/13/2015
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