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NPI Code Detail

MEDICARE: BRIANNE CAMILLA JOHNSEN

MEDICARE: BRIANNE CAMILLA JOHNSEN
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
1235Z00000XSpeech-Language Pathologist7745MN

General Provider Information

NPI Number : 1962562009
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNE CAMILLA JOHNSEN
Provider Business Mailing Address
First Line : 109 COURT AVE S
Second Line :
City : SANDSTONE
State : MN
Zip : 55072-5120
Country : US
Telephone Number : 320-245-2211
Fax Number :
Provider Business Practice Location Address
First Line : 109 COURT AVE S
Second Line :
City : SANDSTONE
State : MN
Zip : 55072-5120
Country : US
Telephone Number : 320-245-2211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 07/08/2007

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Directions to “ BRIANNE CAMILLA JOHNSEN ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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