Individual
STACY KRISTINA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1555 NORTHWAY DR, SAINT CLOUD, MN 56303-4555
(320) 259-4100
(320) 259-8044
Mailing address
1555 NORTHWAY DR, SAINT CLOUD, MN 56303-4555
(320) 259-4100
(320) 259-8044
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R182400-7
MN
Other
Enumeration date
12/12/2007
Last updated
12/12/2007
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