Johnson, Michelle D

Johnson, Michelle D is an individual health care provider with primary practice located at 8940 N Wood Sage Rd , Peoria IL 61615-7822. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Johnson, Michelle D can be contacted via phone (309) 243-3000.

Contact Information

Primary practice address
8940 N Wood Sage Rd Peoria IL 61615-7822
Phone: (309) 243-3000
Fax: (309) 243-3274
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 209011812 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 209011812 Illinois

Profile Details

NPI number 1790186070
LBN Legal business name Johnson, Michelle D
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 5th, 2014
Last updated Oct 4th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1790186070 NPPES
Illinois Other 209.011812 LICENSE

Popular Providers