Individual
CHERYL K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
585 W CHERRY ST, NORTH LIBERTY, IA 52317-9797
(319) 626-6006
(319) 626-3400
Mailing address
PO BOX 260, NORTH LIBERTY, IA 52317-0260
(319) 626-6006
(319) 626-3400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24979
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1024398
—
IA
01
—
251280
WELLMARK
IA
Enumeration date
01/17/2007
Last updated
07/08/2007
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