Individual
MADELINE K JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8100 W 78TH ST STE 230, EDINA, MN 55439-2570
(952) 946-9777
Mailing address
2209 MINNEAPOLIS AVE, MINNEAPOLIS, MN 55406-1432
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
12/27/2017
Last updated
03/11/2021
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