| NPI | 1497640684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA MARIE JOHNSON Managing Member 612-405-9101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health |
| 367A00000X Advanced Practice Midwife | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-06-10 |
| Last Update Date | 2025-06-10 |