Individual
JENNIFER M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
1 CNP, DNP
Contact information
Practice address
640 JACKSON ST - MC11108B, HEALTHPARTNERS REGIONS SPECIALTY CLINICS, ST. PAUL, MN 55101-2502
(651) 254-4816
(651) 254-2801
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(651) 254-2801
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R1450646
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433078100
—
MN
Enumeration date
03/08/2006
Last updated
12/08/2011
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