Individual
JULIE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1511 NORTHWAY DR, STE 103, SAINT CLOUD, MN 56303-1262
(320) 227-5000
(320) 227-5025
Mailing address
1511 NORTHWAY DR, STE 103, SAINT CLOUD, MN 56303-1262
(320) 253-5220
(320) 203-2113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45006
MN
207R00000X
Internal Medicine Physician
45006
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040993600
—
MN
Enumeration date
02/28/2006
Last updated
01/07/2020
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