Doctor Name: | MS. KIRSTEN LEE JOHNSON |
NPI Number: | 1093169567 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN, PHN, CDE |
License Number: | R-157706-6 |
Business Practice Address: | 112033 Warner Cir Chaska, MN - 553181437 |
Business Phone Number: | 9523567549 |
Business Fax Number: | |
Mailing Address: | 112033 Warner Cir, CHASKA |
State: | MN |
Postal Code: | 553181437 |
Phone Number: | 9523567549 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2016 |
NPI Last Update Date: | 04/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WD0400X |
License Number: | R-157706-6 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Diabetes Educator |
Taxonomy Definition: |