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General NPI Number Information
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NPI Number | 1649593716
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Entity Type | Organization
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Legal Business Name | AMY E JOHNSON-GRASS
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Dates
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Enumeration Date | 03/03/2010
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Last Update Date | 07/15/2022
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Provider Practice Location Address
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Address Line | 968 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105
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Country | US
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Telephone | 651-895-2520
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Fax | 651-330-3768
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Provider Business Mailing Address
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Address Line | 968 GRAND AVE
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City | SAINT PAUL
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State | MN
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Zip | 55105
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Country | US
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Telephone | 651-895-2520
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Fax | 651-330-3768
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | STEPHANIE N KEEN-CARLSON
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Credential |
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Telephone | 651-895-2520
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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