Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 59720 | MN |
Y | 207ND0900X | Dermatopathologist | 59720 | MN |
N | 207ND0900X | Dermatopathologist | MD2019-0217 | NM |
NPI | 1033538517 |
---|---|
Provider Name | Emma Fell Johnson |
First Address | Rochester, MN 55905-0002 |
Second Address | Rochester, MN 55905-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2014 |
Last Update Date | 30/09/2020 |