Individual
MS. ANNA CAROL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1200 6TH AVE N, CENTRA CARE CLINIC, SAINT CLOUD, MN 56303-2735
(507) 284-2511
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11256
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/03/2012
Last updated
01/28/2020
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