Individual
BROOKE LAUREN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
24012 98TH ST NW, ELK RIVER, MN 55330-4511
(763) 688-1376
Mailing address
24012 98TH ST NW, ELK RIVER, MN 55330-4511
(763) 688-1376
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
86177040
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86177040
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
09/29/2021
Last updated
09/29/2021
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