Individual provider · Type 1 NPI
Mattie B. Johnson, AGPCNP
Primary Care Nurse Practitioner · Detroit, MI
NPI number
1750808648
Active
Practice location
13599 Virgil St
Detroit, MI 48223-3050
Fax (313) 535-6050
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | 4704224916 (MI) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1750808648
Mattie B. Johnson, AGPCNP's National Provider Identifier is 1750808648, issued on Aug 23, 2017. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Detroit, MI. The record was last updated on Aug 23, 2017.