Individual
MELODY B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
PO BOX 211699, EAGAN, MN 55121-3699
(866) 849-0692
Mailing address
PO BOX 211699, EAGAN, MN 55121-3699
(866) 849-0692
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-16547
NC
363A00000X
Physician Assistant
0110011741
VA
363A00000X
Physician Assistant
085012093
IL
363A00000X
Physician Assistant
Primary
13206
MN
363A00000X
Physician Assistant
137640
IA
363A00000X
Physician Assistant
50.010217RX
OH
363A00000X
Physician Assistant
PA.0009681
CO
363A00000X
Physician Assistant
PA9121569
FL
Other
Enumeration date
09/25/2019
Last updated
05/07/2026
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