Provider Demographics
NPI:1144775420
Name:JOHNSON, LINDSAY MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 E 1ST ST
Mailing Address - Street 2:DULUTH
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805
Mailing Address - Country:US
Mailing Address - Phone:219-249-5555
Mailing Address - Fax:
Practice Address - Street 1:1001 E SUPERIOR ST
Practice Address - Street 2:DULUTH
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2207
Practice Address - Country:US
Practice Address - Phone:218-249-3081
Practice Address - Fax:218-249-3083
Is Sole Proprietor?:No
Enumeration Date:2016-08-17
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4397363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily