Johnson, Jerel Dean

Johnson, Jerel Dean is an individual health care provider with primary practice located at 23 East Vermilion Ave , Cook MN 55723-0127. He recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as his primary health care specialty. Johnson, Jerel Dean can be contacted via phone (218) 666-2879.

Contact Information

Primary practice address
23 East Vermilion Ave Cook MN 55723-0127
Phone: (218) 666-2879
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optician 156FX1800X 19618 Minnesota

Profile Details

NPI number 1750421160
LBN Legal business name Johnson, Jerel Dean
Credentials ABOC OPTICIAN
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Jul 8th, 2007 - about 17 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 1750421160 NPPES
Minnesota Other 66791CO 1ST PLAN BLUE
Minnesota Other 110191 1ST PLAN BLUE
Minnesota Other 2100594 1ST PLAN BLUE
Minnesota Other 66791CO 1ST PLAN BLUE

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