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MR. WILLIAM RUSSELL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CNS

Contact information

Practice address
1 VETERANS DR, MINNEAPOLIS, MN 55417-2309
(612) 467-1771
Mailing address
17335 IDLEWOOD CT, LAKEVILLE, MN 55044-5643
(952) 898-2219

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R0730943
MN

Other

Enumeration date
09/05/2006
Last updated
07/08/2007
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