Healthcare Provider Details

I. General information

NPI: 1497498455
Provider Name (Legal Business Name): KATRINA ELIZABETH JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2022
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 RAILROAD AVE
ALBANY MN
56307-9379
US

IV. Provider business mailing address

30 RAILROAD AVE
ALBANY MN
56307-9379
US

V. Phone/Fax

Practice location:
  • Phone: 320-845-2157
  • Fax: 320-845-6138
Mailing address:
  • Phone: 320-845-2157
  • Fax: 320-845-6138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number76992
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: