MRS. MATTIE B. JOHNSON AGPCNP NPI 1750808648

NPI Information

NPI: 1750808648
Provider Name: MRS. MATTIE B. JOHNSON, AGPCNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

PECOS Registration: Yes

Address:
13599 VIRGIL ST
DETROIT, MI
ZIP 48223
Phone: (313) 535-6050
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MRS. Mattie B. Johnson, AGPCNP is a primary care nurse practitioner in Detroit, MI. MRS. Mattie B. Johnson, AGPCNP NPI is 1750808648. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

13599 VIRGIL ST
DETROIT, MI
ZIP 48223-050
Phone: (313) 535-6050
Fax: (313) 535-6050

The NPI 1750808648 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 8/23/2017 and was last updated on 8/23/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP2300X	Nurse Practitioner	Primary Care	4704224916	MICHIGAN	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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