ICEPHINE BALLARD JOHNSON

SAINT CLOUD, MN
NPI1568430346
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MN  R 107237-0)
Enumeration Date2006-03-09
Last Update Date2023-09-06
Business Address
Mrs. ICEPHINE BALLARD JOHNSON nurse practitioner
720 4TH AVE S
SAINT CLOUD, MN 56301-4442
Phone number: 320-308-4861
Mailing Address
Mrs. ICEPHINE BALLARD JOHNSON nurse practitioner
720 4TH AVE S
SAINT CLOUD, MN 56301-4442
Phone number: 320-308-4861
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