Individual
LIANE MARIE JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 352-4059
(701) 352-9290
Mailing address
1319 W 11TH ST, GRAFTON, ND 58237-2138
(701) 352-4059
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L10558
ND
207Q00000X
Family Medicine Physician
L10558
ND
Other
Enumeration date
11/13/2024
Last updated
11/13/2024
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