Individual
STEPHANIE JO JOHANNECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, AGNP, CNP
Contact information
Practice address
101 WILLMAR AVE SW, WILLMAR, MN 56201-3556
(320) 231-5000
Mailing address
16870 105TH AVE NE, ATWATER, MN 56209-9315
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
6641
MN
Other
Enumeration date
06/20/2019
Last updated
05/25/2023
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