Johnson, Kristine L

Johnson, Kristine L is an individual health care provider with primary practice located at 14000 Nicollet Ave , Burnsville MN 55337-5790. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Johnson, Kristine L can be contacted via phone (952) 428-0200.

Contact Information

Primary practice address
14000 Nicollet Ave Burnsville MN 55337-5790
Phone: (952) 428-0200
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LD2587000 Minnesota

Profile Details

NPI number 1083606263
LBN Legal business name Johnson, Kristine L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Nov 21st, 2011 - about 14 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 1083606263 NPPES
Minnesota MEDICAID 041327500

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