Search › Michigan › 363A00000X
Jacqueline Johanson, P.A.-C
NPI 1952304982 · on the registry since 2005
Practice
- Address
- 310 Lafayette Ave Se Ste 410
Grand Rapids, MI 49503 - Phone
- (616) 685-8200
- Fax
- (616) 685-8202
- Organisation at this address
- Grand Anesthesia Pllc
Trinity Health-Michigan
Grand River Gastroenterology Pc
Grand River Endoscopy Center, L.L.C.
Pine Rest Christian Mental Heatth ServicesInferred from a shared address, not stated in the registry. - Clinicians at this address
- 41
Additional practice sites
- 230 Michigan St Ne Ste 230, Grand Rapids, MI
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-12-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan