MRS. SHANTAE MONAE JOHNSON


Address: 6071 W Outer Dr, Detroit, MI 48235-2624
Phone: 3139666075

MRS. SHANTAE MONAE JOHNSON (NPI# 1417406752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417406752
Entity Type Individual
Full Name MRS. SHANTAE MONAE JOHNSON
Credential AGACNP-BC
Practice Address 6071 W Outer Dr
Detroit
MI 48235-2624
Mailing Address 11331 Hazelton
Redford
MI 48239-1429
Practice Telephone 3139666075
Mailing Telephone 3132316110
Enumeration Date 2016-09-28
Last Update Date 2016-09-28
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2100X Nurse Practitioner
Specialization: Acute Care
4704245204 MI Physician Assistants & Advanced Practice Nursing Providers

Other Providers SHANTAE JOHNSON

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1497304646 Shantae Renee Johnson Driver 560 Big Sioux Ct, Poinciana, FL 34759-5927 2019-09-10
1437468469 Shantae Rae Johnson Doula 2971 Se 92nd Ave, Portland, OR 97266-1429 2010-09-24
1750872487 Shantae Johnson Nurse Practitioner 4441 Capital Ave Sw, Battle Creek, MI 49015-9359 2018-05-30
1467812560 Shantae Johnson Counselor 1500 Lafayette St, Ste 150, Gretna, LA 70053-5799 2016-03-02

Office Location

Street Address 6071 W OUTER DR
City DETROIT
State MI
Zip Code 48235-2624

Providers in the same location

NPI Name Taxonomy Address Enumeration
1205836806 Select Specialty Hospital - Northwest Detroit Inc Long Term Care Hospital 6071 W Outer Dr, 7th Floor, Detroit, MI 48235-2624 2005-07-26
1356965198 Anielle Ball Registered Nurse 6071 W Outer Dr, Detroit, MI 48235-2624 2020-06-07
1427672708 Nitesh Kumar Byrappa Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-06-03
1992327969 Chandima Jinani Herath Mudiyanselage Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235 2020-05-13
1790307783 Patrick Riedy Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-05-12
1518589878 Nnadozie Okoroafor Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-05-09
1720609803 Charmayne Gail Cooley Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-30
1841811890 Noren Din Internal Medicine 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-30
1962023069 Haseeb Khan Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-29
1285255570 Edward Park Student in an Organized Health Care Education/Training Program 6071 W Outer Dr, Detroit, MI 48235-2624 2020-04-28
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1457976292 Ali Nauman Khan Student in an Organized Health Care Education/Training Program Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 2020-06-08
1629690565 Faseeha Arshad Gondal Student in an Organized Health Care Education/Training Program Detroit Medical Center Sinai Grace Hospital, 6071 Outer Dr W. Detroit, Mi 48235, United States, Detroit, MI 48235 2020-05-14
1902428832 Muhanad Abou Touk Student in an Organized Health Care Education/Training Program Dmc - Sinai Grace Hospital, Department of Internal Medi, 6071, W. Outer Drive, Detroit, MI 48235 2020-05-14
1780206730 Ahmad Mismar Student in an Organized Health Care Education/Training Program Detroit Medical Center - Sinai Grace Hospital, Departme, 6071 West Outer Drive, Detroit, MI 48235 2020-05-13
1023630589 Joao Paulo Fontana Bragagnollo Student in an Organized Health Care Education/Training Program 6071 W Outer Drive-sinai Grace Hospital, Department of Medicine 4th Floor M-406, Detroit, MI 48235 2020-05-07
1881216216 Mohammad Awad Jaber Student in an Organized Health Care Education/Training Program 6071 W. Outer Drive, Dmc Sinai-grace Hospital, Detroit, MI 48235 2020-05-07
1366064818 Syeda Busmah Owais Student in an Organized Health Care Education/Training Program 6071 Outer Drive, Sinai Grace Hospital, Department of I, Detroit, MI 48235 2020-05-07
1184245680 Sushmitha Nanja Reddy Student in an Organized Health Care Education/Training Program Detroit Medcen Sinai Grace Hospital Dpt of Internal Med, 6071 W Outer Drive, Detroit, MI 48235 2020-05-06
1972164796 Jack Phillip Tomen Student in an Organized Health Care Education/Training Program Sinai - Grace Hospital, 6071 Outer Drive W, Department of Medicine - 4 Main, Detroit, MI 48235 2019-06-24
1346809464 Anusha Bapatla Student in an Organized Health Care Education/Training Program 4 Main, 6071 West Outer Drive, Sinai-grace Hospital, Department of Internal Medicine, Detroit, MI 48235 2019-06-12
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Taxonomy Information

Taxonomy Code 363LA2100X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Acute Care

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851945687 Walter Mitini Etoh Nurse Practitioner Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 2019-07-30
1811202310 Ronda Lyn Bryant Nurse Practitioner 17600 Ryan Rd, Detroit, MI 48212-1155 2010-08-10
1104902915 Kathleen Ann Brady Nurse Practitioner Henry Ford Hospital, 2799 West Grand Blvd, Detroit, MI 48202 2006-10-27
1619914199 Sheryl Jean Marentette Nurse Practitioner 4646 John R St Ste A3118, Detroit, MI 48201-1916 2006-06-01
1952918740 Lisa Colombo Nurse Practitioner 22101 Moross Rd, Detroit, MI 48236-2148 2020-09-26
1558976928 Ashley Mary Asmar Nurse Practitioner 3990 John R St, Detroit, MI 48201-2018 2020-09-12
1881218790 Erin Marie Dinnell Nurse Practitioner 4201 Saint Antoine St, Detroit, MI 48201-2153 2020-06-05
1780205179 Sabastan Patrick Knight Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2608 2020-04-27
1225673114 Marlon Nicdao Nurse Practitioner 3990 John R St, Detroit, MI 48201-2018 2019-11-14
1265077408 Megan Nicole Hodson Nurse Practitioner 2799 W Grand Blvd, Detroit, MI 48202-2689 2019-11-12
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Competitor

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City DETROIT
Zip Code 48235

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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