Individual
MICHELE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
916 RICE ST, SAINT PAUL, MN 55117-5425
(651) 290-9232
Mailing address
409 DUNLAP ST N, SAINT PAUL, MN 55104-4201
(651) 290-9200
(651) 290-9210
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0995940
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217214300
—
MN
Enumeration date
09/28/2006
Last updated
01/10/2020
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