Individual
KERRY A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP-FNP-DNP
Contact information
Practice address
14000 NICOLLET AVE STE 100, BURNSVILLE, MN 55337-5793
(952) 428-0200
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2764
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111925000
—
MN
Enumeration date
05/16/2006
Last updated
02/16/2018
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