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Individual

LUCY M JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-3100
(701) 234-3120
Mailing address
100 4TH ST S, FARGO, ND 58103-1929
(701) 234-3100
(701) 234-3120

Taxonomy

Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
R20985
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300019200
MN
05
70010
ND
05
70011
ND
Enumeration date
07/18/2006
Last updated
10/16/2012
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