Individual
MISS ELISE H JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4194 LEXINGTON AVE N, SHOREVIEW, MN 55126
(651) 483-5461
Mailing address
260 COBBLESTONE DR, COLORADO SPRINGS, CO 80906-7624
(320) 224-6038
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
56936
MN
Other
Enumeration date
05/16/2012
Last updated
03/27/2019
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