Individual
MARISSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5500 94TH AVE N, BROOKLYN PARK, MN 55443-1992
(952) 826-8475
Mailing address
5500 94TH AVE N, BROOKLYN PARK, MN 55443-1992
(952) 826-8475
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
2226565
MN
Other
Enumeration date
02/11/2026
Last updated
02/11/2026
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