Individual
JANELLE L JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 CENTRACARE CIRCLE, ST CLOUD, MN 56303
(320) 654-3630
(320) 654-3657
Mailing address
1900 CENTRACARE CIRCLE, ST CLOUD, MN 56303
(320) 654-3630
(320) 654-3657
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
45236
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1032225
PREFERRED ONE
—
01
—
1202293
MEDICA HEALTH PLANS
—
01
—
142738
U CARE
—
01
—
1679007
ARAZ GRP AMERICA'S PPO
—
01
—
2130072
FIRST HEALTH PLAN
—
01
—
318J2JO
BLUE CROSS BLUE SHIELD
—
01
—
HP35801
HEALTH PARTNERS
—
Enumeration date
10/31/2005
Last updated
07/08/2007
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