Individual
JAN DIANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4001 STINSON BLVD, STE 404, MINNEAPOLIS, MN 55421-3488
(612) 706-9630
Mailing address
900 LONG LAKE RD, STE 160, NEW BRIGHTON, MN 55112-6414
(651) 631-3759
(612) 706-9617
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
25663
MN
Other
Enumeration date
07/28/2005
Last updated
03/24/2017
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