Johnson, Mary Therese
Johnson, Mary Therese is an individual health care provider with primary practice located at 1221 Whipple St , Eau Claire WI 54703-5270. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnson, Mary Therese can be contacted via phone (715) 552-5346.Contact Information
Primary practice address
1221 Whipple St
Eau Claire WI 54703-5270
Phone: (715) 552-5346
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 2374-033 | Wisconsin |
Profile Details
| NPI number | 1518935717 |
|---|---|
| LBN Legal business name | Johnson, Mary Therese |
| Credentials | RN, APRN |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 14th, 2006 |
| Last updated | Mar 30th, 2021 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518935717 | NPPES |
| Wisconsin | MEDICAID | 41195400 |
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