Individual provider · Type 1 NPI

Shantae Monae Johnson, AGACNP-BC

Acute Care Nurse Practitioner · Detroit, MI

NPI number 1417406752 Active

Practice location

100 Mack Ave Fl 1
Detroit, MI 48201-2416

Call (313) 818-8207 Map

Mailing address

11331 Hazelton
Redford, MI 48239-1429

Other practice locations

  • 6071 W Outer Dr, Detroit, MI 48235-2624 · (313) 966-6075

Specialties and licenses

TaxonomyCodeLicense
Acute Care Nurse Practitioner Primary 363LA2100X4704245204 (MI)

Acute Care Nurse Practitioner: Definition to come...

3 other providers at this address

Other acute care nurse practitioner providers in Detroit

See all in Detroit →

About NPI 1417406752

Shantae Monae Johnson, AGACNP-BC's National Provider Identifier is 1417406752, issued on Sep 28, 2016. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Detroit, MI. The record was last updated on Jul 29, 2025.