Individual
MS. STEPHANI ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 JACKSON STREET, MS11102F, ST. PAUL, MN 55101
(651) 254-5216
(651) 254-5216
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5790
(952) 853-8727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2080
MN
Other
Enumeration date
06/17/2014
Last updated
02/28/2019
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