NPI 1437554482 · live from the CMS NPI Registry
Gregory M Johnson, APRN,CNP
Nurse Practitioner, Pediatrics in Park Rapids, MN. National Provider Identifier 1437554482, active.
NPI record
| NPI | 1437554482 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 705 Pleasant Ave S, Park Rapids, MN 56470 |
| Practice phone | 218-732-2800 |
| Mailing address | 1702 University Dr S, Fargo, ND 58103 |
| Enumerated | November 1, 2014 |
| Last updated | February 25, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 3084 (MN) |
| Registered Nurse | 163W00000X | R 223267-2 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.