Provider Demographics
NPI:1326625989
Name:JOHNSON, CINNAMON
Entity Type:Individual
Prefix:MS
First Name:CINNAMON
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 SOUTHLAWN CT
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-1817
Mailing Address - Country:US
Mailing Address - Phone:989-482-8576
Mailing Address - Fax:
Practice Address - Street 1:9 SOUTHLAWN CT
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-1817
Practice Address - Country:US
Practice Address - Phone:989-482-8576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-28
Last Update Date:2021-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies