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Individual

CARLA RAE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
3366 OAKDALE AVE N, SUITE 551, MINNEAPOLIS, MN 55422-2948
(763) 587-7737
(763) 587-7069
Mailing address
9201 W BROADWAY AVE, SUITE 601, BROOKLYN PARK, MN 55445-1923
(763) 587-7974

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
AG0713025
MN

Other

Enumeration date
08/06/2013
Last updated
08/06/2013
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