MEDICARE: HELEN JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant		MN

General Provider Information

NPI Number	:	1881788719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN JOHNSON

Provider Business Mailing Address
First Line	:	2118 1ST AVE NE
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-4339
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2118 1ST AVE NE
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-4339
Country	:	US
Telephone Number	:	507-433-8995
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/08/2007

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Directions to “ HELEN JOHNSON ” Practice Location

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