| Doctor Name: | KIMBERLY ANN JOHNSON |
| NPI Number: | 1295014520 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CNP |
| License Number: | R-171634-8 |
| Business Practice Address: | 40 11th St Cloquet, MN - 557201817 |
| Business Phone Number: | 2188794559 |
| Business Fax Number: | 2188790282 |
| Mailing Address: | 1401 E 1st St, DULUTH |
| State: | MN |
| Postal Code: | 558052407 |
| Phone Number: | 2187284491 |
| Fax Number: | 2187284404 |
| NPI Enumeration Date: | 08/04/2011 |
| NPI Last Update Date: | 09/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | R-171634-8 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |