Individual
BETHANY LAUREN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
(612) 672-8992
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 372-7422
(612) 672-8992
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10647
MN
Other
Enumeration date
08/25/2009
Last updated
09/12/2018
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