Healthcare Provider Details

I. General information

NPI: 1326487828
Provider Name (Legal Business Name): CIZZARIE LEANN JOHNSON SCHOMBERG CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CIZZARIE L JOHNSON

II. Dates (important events)

Enumeration Date: 06/18/2013
Last Update Date: 01/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 E 3RD ST
DULUTH MN
55805-1951
US

IV. Provider business mailing address

400 E 3RD ST
DULUTH MN
55805-1951
US

V. Phone/Fax

Practice location:
  • Phone: 218-786-8490
  • Fax:
Mailing address:
  • Phone: 218-786-8490
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR-145452-9
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: