Individual
MRS. ICEPHINE BALLARD JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
720 4TH AVE S, SAINT CLOUD, MN 56301-4442
(320) 308-4861
(320) 308-3192
Mailing address
720 4TH AVE S, SAINT CLOUD, MN 56301-4442
(320) 308-4861
(320) 308-3192
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R 107237-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41687554
EIN
MN
Enumeration date
03/09/2006
Last updated
09/06/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us