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Individual

ADAM TOD JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
240 MAPLE ST, WOODRUFF, WI 54568-9190
(715) 356-8000
Mailing address
PO BOX 118, PRESQUE ISLE, WI 54557-0118
(715) 482-4520

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10228-33
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10288-33
STATE LICENSE NUMBER
WI
Enumeration date
08/03/2020
Last updated
08/03/2020
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