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Individual

TERI LEE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, NNP-BC

Contact information

Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6295
Mailing address
4724 BLAISDELL AVE, MINNEAPOLIS, MN 55419-5505
(612) 824-4230

Taxonomy

Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
JOH1-0437-1301
MN

Other

Enumeration date
07/09/2012
Last updated
07/09/2012
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