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General NPI Number Information
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NPI Number | 1568235489
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Entity Type | Individual
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Provider Name | BRIANNA NICOLE JOHNSON OD
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Gender | Female
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Dates
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Enumeration Date | 11/02/2023
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 9801 DUPONT AVE S STE 200
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City | BLOOMINGTON
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State | MN
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Zip | 55431-3200
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Country | US
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Telephone | 952-888-5800
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Fax | 952-567-6156
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Provider Business Mailing Address
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Address Line | 300 2ND AVE NE
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City | JAMESTOWN
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State | ND
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Zip | 58401-3373
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Country | US
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Telephone | 701-252-2020
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 815
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License Number State | ND
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3993
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License Number State | MN
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