Jacqueline S Johanson in Grand Rapids - Physician Assistant
Jacqueline S Johanson - NPI 1952304982
Jacqueline S Johanson is a Physician Assistant in Grand Rapids, Michigan. Jacqueline S Johanson practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Jacqueline S Johanson is 1952304982. The last update date is 2021-12-28.
Jacqueline S Johanson's current location address is 310 Lafayette Ave Se Ste 410, Grand Rapids, Michigan. You can contact this provider via phone number 6166858200 and fax number 6166858202. The mailing address for Jacqueline S Johanson is 310 Lafayette Ave Se Ste 410, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | Jacqueline S Johanson |
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Address | 310 Lafayette Ave Se Ste 410, Grand Rapids, Michigan |
Phone Number | 6166858200 |
Fax Number | 6166858202 |
Sole Proprietor | N |
Credentials | P.A.-C |
NPI Number Detail
NPI Number | 1952304982 |
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Provider Enumeration Date | 2005-05-23 |
Last Updated Date | 2021-12-28 |
Provider Mailing Address Detail
Address | 310 Lafayette Ave Se Ste 410 |
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City | Grand Rapids |
State | Michigan (MI) |
Post Code | 4950346930 |
Phone Number | 6166858200 |
Fax Number | 6166858202 |
Provider's Primary Taxonomy Detail
Speciality | Physician Assistant |
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Taxonomy | 363A00000X |
Licence No | 5601008301 |
Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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What is the unique identification code assigned to Jacqueline S Johanson by the Centers for Medicare & Medicaid Services?
The Jacqueline S Johanson has been issued the NPI (National Provider Identifier) 1952304982. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Jacqueline S Johanson is located?
The Jacqueline S Johanson is situated at the following address: 310 Lafayette Ave Se Ste 410, Grand Rapids, MI, 4950346930.
What is Jacqueline S Johanson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Jacqueline S Johanson is Physician Assistant, and the corresponding taxonomy classification code for this specialized field is 363A00000X.
On what date did Jacqueline S Johanson receive its 1952304982 assignment from the Centers for Medicare & Medicaid Services?
The Jacqueline S Johanson was assigned its 1952304982 on 2005-05-23, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Jacqueline S Johanson last refreshed?
The information related to the Jacqueline S Johanson, including its address, specialty, and other relevant details, was last updated on 2021-12-28.
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