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NPI Code Detail

MEDICARE: ELIZABETH TWEETEN JOHNSON RN, BSN

MEDICARE: ELIZABETH TWEETEN JOHNSON RN, BSN
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
1163WD0400XDiabetes Educator Registered Nurse90418WI

General Provider Information

NPI Number : 1366418303
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH TWEETEN JOHNSON RN, BSN
Provider Business Mailing Address
First Line : 1750 RANGE TRL
Second Line :
City : VERONA
State : WI
Zip : 53593-9353
Country : US
Telephone Number : 608-220-6076
Fax Number :
Provider Business Practice Location Address
First Line : 1700 TUTTLE ST
Second Line :
City : BARABOO
State : WI
Zip : 53913-3319
Country : US
Telephone Number : 608-355-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 03/13/2023

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