NPI 1922697465 · live from the CMS NPI Registry
Shawnna C Johnson, APRN,CNP
Nurse Practitioner, Pediatrics in Baxter, MN. National Provider Identifier 1922697465, active.
NPI record
| NPI | 1922697465 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 13060 Isle Dr, Baxter, MN 56425 |
| Practice phone | 218-828-2880 |
| Mailing address | 1702 South University Drive, Medical Staff Services, Fargo, ND 58103 |
| Enumerated | January 11, 2021 |
| Last updated | January 11, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 7908 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.