Healthcare Provider Details

I. General information

NPI: 1093633836
Provider Name (Legal Business Name): ADRIANNA JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W MAIN ST
PIPESTONE MN
56164-1633
US

IV. Provider business mailing address

48648 240TH ST
JASPER MN
56144-1061
US

V. Phone/Fax

Practice location:
  • Phone: 605-850-3581
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number14385
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: