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NPI Code Detail

MEDICARE: MR. GERON DEMARCUS JOHNSON REGISTERED NURSE

MEDICARE: MR. GERON DEMARCUS JOHNSON REGISTERED NURSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse4704286834MI

General Provider Information

NPI Number : 1689006470
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GERON DEMARCUS JOHNSON REGISTERED NURSE
Provider Business Mailing Address
First Line : 1 SKYHAVEN CT
Second Line :
City : SAGINAW
State : MI
Zip : 48604-1820
Country : US
Telephone Number : 989-992-6739
Fax Number :
Provider Business Practice Location Address
First Line : 1040 W BRISTOL RD
Second Line :
City : FLINT
State : MI
Zip : 48507-5516
Country : US
Telephone Number : 810-618-6770
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2013
Last Update Date : 03/03/2026

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