Individual
EMMA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4300 MARKETPOINTE DR STE 100, BLOOMINGTON, MN 55435-5435
(952) 857-1519
Mailing address
228 CHERRY HILL TRL, MEDINA, MN 55340-9317
(763) 245-2341
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14586
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/05/2022
Last updated
10/18/2023
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