Healthcare Provider Details

I. General information

NPI: 1073841227
Provider Name (Legal Business Name): KAREN L. JOHNSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2009
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 W DAKOTA PKWY
WILLISTON ND
58801-3807
US

IV. Provider business mailing address

PO BOX 5010
MINOT ND
58702-5010
US

V. Phone/Fax

Practice location:
  • Phone: 701-572-7711
  • Fax:
Mailing address:
  • Phone: 701-418-8000
  • Fax: 701-857-3430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License NumberR26738
License Number StateND
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberR26738
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: