Individual
JENNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9900 BREN RD EAST, MAIL ROUTE MN 008-B213, MINNETONKA, MN 55343
(480) 490-3507
Mailing address
PO BOX 1459, MINNEAPOLIS, MN 55440-1459
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
95011251
CA
363LF0000X
Family Nurse Practitioner
813759
NV
363LF0000X
Family Nurse Practitioner
Primary
AP11439
AZ
363LF0000X
Family Nurse Practitioner
NP60908265
WA
Other
Enumeration date
12/11/2010
Last updated
05/03/2021
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