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Individual

KATHERINE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
4801 VETERANS DR, SAINT CLOUD, MN 56303-2015
(320) 360-1291
Mailing address
11087 TIMBERLOST RD, LITTLE FALLS, MN 56345-6231
(320) 360-1291

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
74741-5
MN

Other

Enumeration date
05/16/2013
Last updated
05/16/2013
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