Individual
JILL M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7600 FRANCE AVE S STE 4100, EDINA, MN 55435
(952) 831-1551
Mailing address
7250 FRANCE AVE S STE 410, EDINA, MN 55435-4314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
42917
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080184793
RAILROAD MEDICARE
—
01
—
63G80JO
BCBS OF MN
MN
Enumeration date
03/17/2006
Last updated
07/18/2018
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