MRS. MATTIE B. JOHNSON (NPI# 1750808648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750808648 |
| Entity Type | Individual |
| Full Name | MRS. MATTIE B. JOHNSON |
| Credential | AGPCNP |
| Practice Address |
13599 Virgil St Detroit MI 48223-3050 |
| Practice Telephone | 3135356050 |
| Practice Fax Number | 3135356050 |
| Mailing Telephone | 3135356050 |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
4704224916 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639548829 | Mattie Johnson | Chore Provider | 20232 Hanna St, Detroit, MI 48203-1223 | 2015-09-18 |
| 1689805814 | Mattie Renee Johnson | Licensed Practical Nurse | 784 E 157th St, Cleveland, OH 44110-3037 | 2009-08-05 |
| Street Address |
13599 VIRGIL ST |
| City | DETROIT |
| State | MI |
| Zip Code | 48223-3050 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366946659 | From Heavens Joy Assisted Care Support Services LLC | Social Worker | 14179 Evergreen Rd, Detroit, MI 48223 | 2018-03-21 |
| 1164921144 | Kyara Mccraney | Licensed Practical Nurse | 12725 Riverview St, Detroit, MI 48223 | 2018-02-06 |
| 1922516384 | Cynthia Clair Reese | Nursing Home Administrator | 22625 Glendale, Det, MI 48223 | 2018-01-18 |
| 1629590609 | Marie Davis | Nursing Care | 14049 Minock St, Detroit, MI 48223 | 2017-07-12 |
| 1740726488 | Tanisha Smith | Behavior Technician | 14620 Faust Ave, Detroit, MI 48223 | 2017-01-18 |
| 1518418730 | Tamica K Boyd | Emergency Medical Technician, Basic | 15890 Lamphere, Detroit, MI 48223 | 2016-10-24 |
| 1831596832 | Walter Ector | Counselor | 14243 Minock, Detroit, MI 48223 | 2014-11-20 |
| 1336568542 | Sheryl A Ali | Registered Nurse | 12811 Hazelton Street, Detroit, MI 48223 | 2014-04-15 |
| 1255667556 | Abyssinia Love Knot Physical Therapy LLC | Physical Medicine & Rehabilitation | 15340 Southfield Freeway, Suite 1-a, Detroit, MI 48223 | 2009-10-22 |
| 1629243902 | Glenda Faye Smith | Massage Therapist | 15041 Faust, Detroit, MI 48223 | 2008-04-28 |
| Find all providers in zip 48223 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184176984 | Amanda Marie Allmacher | Nurse Practitioner | 50 E Canfield St Ste 101-s, Detroit, MI 48201-1804 | 2016-10-27 |
| 1144774472 | Angela Jayne Wolf | Nurse Practitioner | 7409 2nd Ave, Apt. A2, Detroit, MI 48202-2700 | 2016-08-03 |
| 1912263914 | Tonia Anitra Willis | Nurse Practitioner | 14102 Saint Marys St, Detroit, MI 48227 | 2012-04-04 |
| 1861624058 | Angela Faye Woodley-williams | Nurse Practitioner | 11260 E Jefferson Ave, Detroit, MI 48214-3320 | 2009-08-20 |
| 1740394055 | Mary Patricia Lange | Nurse Practitioner | 4601 John R, Detroit, MI 48201 | 2006-08-17 |
| 1346848827 | Tanya L Locke | Nurse Practitioner | 22101 Moross Rd, Detroit, MI 48236-2148 | 2020-10-15 |
| 1720621279 | Rachel Campbell | Nurse Practitioner | 5716 Michigan Ave, Detroit, MI 48210-3039 | 2019-10-28 |
| 1124679188 | Shanta Nicole Brown | Nurse Practitioner | 16181 Hubbell St, Detroit, MI 48235-4026 | 2019-09-21 |
| 1851866396 | Christopher Childers | Nurse Practitioner | 4160 John R St Ste 930, Detroit, MI 48201-2017 | 2018-10-11 |
| 1467983940 | Regina Johnson | Nurse Practitioner | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2017-03-25 |
| Find all providers in DETROIT | ||||
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| 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.