Provider Demographics
NPI:1003898081
Name:JOHNSON, BARBARA ANN (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4737 COUNTY ROAD 101
Mailing Address - Street 2:STE 124
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55345-2634
Mailing Address - Country:US
Mailing Address - Phone:612-710-3671
Mailing Address - Fax:763-295-4946
Practice Address - Street 1:4737 COUNTY ROAD 101
Practice Address - Street 2:STE 124
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55345-2634
Practice Address - Country:US
Practice Address - Phone:612-710-3671
Practice Address - Fax:763-295-4946
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN400192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1564702OtherMEDICA
MN137T1J0OtherBCBS OF MN
MN137T1J0OtherBCBS OF MN