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Individual

DR. KARA DURICK JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
12771 RIVERDALE BLVD NW, SUITE 103, COON RAPIDS, MN 55448-1262
(763) 421-1220
(763) 421-1291
Mailing address
12771 RIVERDALE BLVD NW, SUITE 103, COON RAPIDS, MN 55448-1262
(763) 421-1220
(763) 421-1291

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2732
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005323600
MN CARE
MN
01
04S60DU
BLUE CROSS BLUE SHIELD
MN
01
131053
UCARE
MN
01
2200839
MEDICA
MN
01
2200840
MEDICA
MN
01
30187
EYEMED
MN
01
847271021774
PREFERRED ONE
MN
01
921871021774
PREFERRED ONE
MN
Enumeration date
09/28/2006
Last updated
05/28/2014
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