Individual
NICOLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
2550 UNIVERSITY AVE W, SUITE 216S, SAINT PAUL, MN 55114-1052
(952) 977-1801
Mailing address
2550 UNIVERSITY AVE W, SUITE 216S, SAINT PAUL, MN 55114-1052
(952) 993-5333
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
3478
MN
Other
Enumeration date
07/20/2015
Last updated
01/06/2017
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