LAKREESE JOHNSON PAC
NPI 1508186156
Physician Assistant - Medical in Jackson, MI
Active since June 06, 2010
About Lakreese Johnson Pac NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LAKREESE JOHNSON PAC (NPI 1508186156) is an individual medical provider in Jackson, Michigan, licensed in Michigan (5601005679) and active in the NPI registry since June 2010.
NPPES Registry Identity
NPI1508186156
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameLAKREESE JOHNSONCredential: PAC
Location Address3855 COOPER STJackson, MI 49201-7547
Mailing Address3855 Cooper StJackson, MI 49201-7547 · (517) 780-5991
Phone(517) 780-5991
Sole ProprietorNo
Enumeration DateJune 6, 2010
Last NPPES UpdateDecember 13, 2017
✔ NPI 1508186156 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses 2
★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in MI · 5601005679
Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 5601005679 (MI)
3855 COOPER ST, Jackson, MI 49201
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Psychiatry & Neurology (Psychiatry)
3855 COOPER ST, CHARLES EGELER RECEPTION & GUIDANCE CENTER
JACKSON, MI 49201
JACKSON, MI 49201
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1508186156, enumerated as an "individual" on June 06, 2010.
The provider is located at 3855 COOPER ST JACKSON, MI 49201 and the phone number is (517) 780-5991.
Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.
