Individual
MS. DEBRA JO JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2545 CHICAGO AVE, MINNEAPOLIS, MN 55404-4522
(612) 863-4876
(612) 863-2596
Mailing address
30 W 107TH ST, BLOOMINGTON, MN 55420-5502
(952) 881-8649
(612) 863-2596
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R087208-9
MN
Other
Enumeration date
06/07/2006
Last updated
07/08/2007
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