Mindi Lynne Johnson, DNP, RN, AGCNS-BC

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

4704246822 Issued in MI

Practice address

436 Stewart Ave
Lincoln Park, MI 48146-3126

Phone

(734) 365-2821

NPI assigned

Feb 29, 2024

Last updated

Feb 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709164800000",
    "number": "1679330328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 STEWART AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463126",
            "telephone_number": "734-365-2821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 STEWART AVE",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481463126",
            "telephone_number": "734-365-2821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MINDI",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "DNP, RN, AGCNS-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MI",
            "license": "4704246822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gabrielle S Jackson, MA
• Tyler Jackson, LLMSW
• Amanda Jevahirian, NP
• Jalen Johnson
• Marway Sharon Johnson, LMSW
• Zenique M Johnson
• Tange Jones-Berry
• Chloe Jones-Washington
• Lanaya Jones
• Naquana N Jones

• Pediatric Registered Nurse in Lincoln Park, MI
• Providers in Lincoln Park, MI by specialty
• Pediatric Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.