Individual provider · Type 1 NPI
Michael J. Johnson
Psychiatric/Mental Health Nurse Practitioner · Cedar Rapids, IA
NPI number
1104175405
Active
Practice location
1026 A Ave NE
Cedar Rapids, IA 52402-5036
Mailing address
2826 W Locust St
Davenport, IA 52804-3354
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 209009740 (IL) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | G094270 (IA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1104175405
Michael J. Johnson's National Provider Identifier is 1104175405, issued on Aug 31, 2012. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Cedar Rapids, IA. The record was last updated on Sep 29, 2020.