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NPI Code Detail

MEDICARE: PALOMA JOHNSON R.N.

MEDICARE:   PALOMA  JOHNSON  R.N.
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
1163W00000XRegistered Nurse191107-9MN

General Provider Information

NPI Number : 1497166086
Entity Type Code : Individual
Provider Name (Legal Business Name) : PALOMA JOHNSON R.N.
Provider Business Mailing Address
First Line : 5706 SQUIRE LN
Second Line :
City : SAINT PAUL
State : MN
Zip : 55112-1237
Country : US
Telephone Number : 763-571-8887
Fax Number :
Provider Business Practice Location Address
First Line : 10077 DOGWOOD ST NW STE 110
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55448-5285
Country : US
Telephone Number : 763-792-9471
Fax Number : 763-792-9472
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2014
Last Update Date : 05/16/2014

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Directions to “ PALOMA JOHNSON R.N.” Practice Location

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