Individual
JESSICA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(651) 254-3456
Mailing address
16729 CROCUS ST NW, ANDOVER, MN 55304-2061
(612) 207-9939
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/12/2023
Last updated
02/02/2024
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