Individual
CAROLYN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3333 HARBOR LN N APT 6-303, PLYMOUTH, MN 55447-8854
(208) 699-1276
Mailing address
3333 HARBOR LN N APT 6-303, PLYMOUTH, MN 55447-8854
(208) 699-1276
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
818308
MN
Other
Enumeration date
01/30/2022
Last updated
01/30/2022
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