Individual
MEGAN PAMELA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6405 FRANCE AVE S STE W400, EDINA, MN 55435-2165
(952) 920-2730
(952) 567-7090
Mailing address
6405 FRANCE AVE S STE W400, EDINA, MN 55435-2165
(952) 920-2730
(952) 567-7090
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085.003910
IL
363A00000X
Physician Assistant
Primary
11292
MN
363A00000X
Physician Assistant
1862
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
11/17/2010
Last updated
03/17/2018
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