Individual
MBUOTIDEM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4621 SNELLING AVE APT 307, MINNEAPOLIS, MN 55406-4470
(678) 787-8059
Mailing address
4621 SNELLING AVE APT 307, MINNEAPOLIS, MN 55406-4470
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2527958
MN
Other
Enumeration date
04/29/2026
Last updated
04/29/2026
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