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Individual
MRS. MARY JO JOHNSON
Active
Individual
MRS. MARY JO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, CNP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R123626-8
MN
367A00000X
Advanced Practice Midwife
Primary
R123626-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
642215200
—
MN
Enumeration date
09/30/2005
Last updated
02/12/2024
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