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NPI Code Detail

MEDICARE: JULIE A. J. JOHNSON FNP

MEDICARE: JULIE A. J. JOHNSON FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2100XAcute Care Nurse PractitionerR27649ND

General Provider Information

NPI Number : 1134203805
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIE A. J. JOHNSON FNP
Provider Business Mailing Address
First Line : 1010 S BIRCH AVE
Second Line : BOX 700
City : HALLOCK
State : MN
Zip : 56728-4215
Country : US
Telephone Number : 218-843-3612
Fax Number :
Provider Business Practice Location Address
First Line : 1010 S BIRCH AVE
Second Line : BOX 700
City : HALLOCK
State : MN
Zip : 56728-4215
Country : US
Telephone Number : 218-843-3612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 01/18/2013

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