Provider Demographics
NPI:1225361793
Name:JOHNSON, LAURA EVA (RN,CNP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:EVA
Last Name:JOHNSON
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Gender:F
Credentials:RN,CNP
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Mailing Address - Street 1:451 E SAINT GERMAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56304-4649
Mailing Address - Country:US
Mailing Address - Phone:320-252-9526
Mailing Address - Fax:320-252-4710
Practice Address - Street 1:451 E SAINT GERMAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56304-4649
Practice Address - Country:US
Practice Address - Phone:320-252-9526
Practice Address - Fax:320-252-4710
Is Sole Proprietor?:No
Enumeration Date:2009-09-15
Last Update Date:2011-08-24
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Provider Licenses
StateLicense IDTaxonomies
MNR153468-5363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health