Individual
NINA JOHNSON DEANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
15146 16TH AVE, MARNE, MI 49435-9605
(844) 776-9651
Mailing address
15146 16TH AVE, MARNE, MI 49435-9605
(844) 776-9651
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704316882
MI
Other
Enumeration date
01/17/2023
Last updated
09/28/2023
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