Individual
ELLY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
5009 S LOUISE AVE, SIOUX FALLS, SD 57108-2268
(605) 799-1272
Mailing address
403 LIEN AVE, HARRISBURG, SD 57032-4312
(605) 677-8093
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R047341
SD
363LF0000X
Family Nurse Practitioner
Primary
CP001949
SD
Other
Enumeration date
09/23/2021
Last updated
09/23/2021
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