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Individual

SHAWNNA C JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN,CNP

Contact information

Practice address
13060 ISLE DR, BAXTER, MN 56425-8331
(218) 828-2880
Mailing address
1702 SOUTH UNIVERSITY DRIVE, MEDICAL STAFF SERVICES, FARGO, ND 58103-4940

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
7908
MN

Other

Enumeration date
01/11/2021
Last updated
01/11/2021
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