Individual
MS. ROXANNE MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
802 PAUL BUNYAN DR S STE 12&13, BEMIDJI, MN 56601-3201
(218) 444-4323
(218) 444-7514
Mailing address
802 PAUL BUNYAN DR S STE 12&13, BEMIDJI, MN 56601-3201
(218) 407-0210
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
2372
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372
LICENSURE
MN
Enumeration date
04/22/2009
Last updated
07/24/2023
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