Individual
DOMINIQUE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6809 TIMBER RIDGE DR S, COTTAGE GROVE, MN 55016-4776
(612) 513-3778
Mailing address
6809 TIMBER RIDGE DR S, COTTAGE GROVE, MN 55016-4776
(612) 513-3778
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
2469227
MN
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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