Provider Demographics
NPI:1124203864
Name:JOHNSON, LONDA SUSANNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LONDA
Middle Name:SUSANNE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LONDA
Other - Middle Name:
Other - Last Name:TINGELSTAD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1042
Mailing Address - Street 2:320 10TH ST
Mailing Address - City:HAWLEY
Mailing Address - State:MN
Mailing Address - Zip Code:56549
Mailing Address - Country:US
Mailing Address - Phone:218-483-1141
Mailing Address - Fax:
Practice Address - Street 1:106 NORTH 4TH AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-1034
Practice Address - Country:US
Practice Address - Phone:218-998-3778
Practice Address - Fax:218-998-3187
Is Sole Proprietor?:No
Enumeration Date:2007-12-31
Last Update Date:2007-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR1374146163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse