Individual
TIFFANY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1425 109TH LN NW, COON RAPIDS, MN 55433-4214
(763) 438-4713
Mailing address
1425 109TH LN NW, COON RAPIDS, MN 55433-4214
(763) 438-4713
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2196925
MN
Other
Enumeration date
09/17/2018
Last updated
09/17/2018
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