Individual
CORY JOSEPH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1702 SOUTHGATE DR, BUFFALO, MN 55313-4479
(320) 761-0057
Mailing address
1702 SOUTHGATE DR, BUFFALO, MN 55313-4479
(320) 761-0057
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11270
MN
Other
Enumeration date
02/08/2024
Last updated
02/08/2024
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