Individual
JEWEL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11555 BOULDER CT, MAPLE GROVE, MN 55311-7521
(612) 351-7100
Mailing address
11555 BOULDER CT, MAPLE GROVE, MN 55311-7521
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
12799
MN
Other
Enumeration date
09/08/2025
Last updated
09/08/2025
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