Johnson, Jacquelyn Lee

Johnson, Jacquelyn Lee is an individual health care provider with primary practice located at 811 2Nd St Se Suite A, Little Falls MN 56345-3559. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Johnson, Jacquelyn Lee can be contacted via phone (320) 631-7000.

Contact Information

Primary practice address
811 2Nd St Se Suite A Little Falls MN 56345-3559
Phone: (320) 631-7000
Fax: (320) 632-0534
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X R108719-0 Minnesota

Profile Details

NPI number 1891710984
LBN Legal business name Johnson, Jacquelyn Lee
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Feb 16th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891710984 NPPES
Other 0107328 MEDICA
Other 140376C736 MEDICA
Other HP33899 MEDICA
Other A024 MEDICA
Other NA9231028468 MEDICA
MEDICAID 044997100 MEDICA
Other 47G13JO MEDICA

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