| Doctor Name: | MRS. SANDY JO JOHNSON |
| NPI Number: | 1356650238 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | BSN |
| License Number: | R106445-6 |
| Business Practice Address: | 20132 Ulysses Street. Nw Elk River, MN - 55330 |
| Business Phone Number: | 7637538658 |
| Business Fax Number: | 7637534314 |
| Mailing Address: | 4701 147th Lane, ANDOVER |
| State: | MN |
| Postal Code: | 55304 |
| Phone Number: | 7632265897 |
| Fax Number: | |
| NPI Enumeration Date: | 09/27/2010 |
| NPI Last Update Date: | 09/27/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WH0200X |
| License Number: | R106445-6 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Home Health |
| Taxonomy Definition: | |