Johnston, Mary

Johnston, Mary is an individual health care provider with primary practice located at 701 Park Ave , Minneapolis MN 55415-1623. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Johnston, Mary can be contacted via phone (612) 873-6005.

Contact Information

Primary practice address
701 Park Ave Minneapolis MN 55415-1623
Phone: (612) 873-6005
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R132394-8 Minnesota

Profile Details

NPI number 1629039821
LBN Legal business name Johnston, Mary
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2006
Last updated Jan 25th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629039821 NPPES
Minnesota Other 209K1JO BCBS
Minnesota MEDICAID 233677400 BCBS
Minnesota Other HP32961 BCBS
Minnesota Other NA9021032953 BCBS
Minnesota Other 171175 BCBS
Minnesota Other 01-73347 BCBS

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