Individual provider · Type 1 NPI

Nicholas David Johnson, PA

Medical Physician Assistant · Grand Rapids, MI

NPI number 1427558477 Active

Practice location

200 Jefferson Ave SE
Grand Rapids, MI 49503-4502

Mailing address

1900 44th St SE
Kentwood, MI 49508-5008

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X5601008568 (MI)

Medical Physician Assistant: Definition to come...

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About NPI 1427558477

Nicholas David Johnson, PA's National Provider Identifier is 1427558477, issued on Feb 16, 2018. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Grand Rapids, MI. The record was last updated on Feb 16, 2018.