Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Shantae Monae Johnson, AGACNP-BC

Individual provider Acute Care Nurse Practitioner · NPI 1417406752

Mrs. Shantae Monae Johnson, AGACNP-BC is a Nurse Practitioner in Detroit, Michigan. Qualified in 2016, 10 years ago. Practices as a sole proprietor, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
10
Licensed in
MI
In the registry since
2016
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

100 Mack Ave Fl 1
Detroit, MI 48201-2416
Phone: (313) 818-8207
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6071 W Outer Dr, Detroit, MI 48235-2624 — (313) 966-6075

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 4704245204 (MI)

Record details

NPI number1417406752
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGACNP-BC
Sole proprietorYes
NPI enumeratedSeptember 28, 2016
Last updated in NPPESJuly 29, 2025
Certification dateJuly 29, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Detroit