Individual
MARY ANN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 COMANCHE RD, FORT MEADE, SD 57741-1002
(605) 720-7129
Mailing address
2841 WILKIE DR APT 205, RAPID CITY, SD 57702-9790
(605) 720-7129
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
NUR-LPN-LIC-6884
MT
Other
Enumeration date
04/23/2026
Last updated
04/23/2026
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