NPI 1023206935

Tamara a Johnson, PAC

Practitioner Physician Assistant St Louis Park, MN

Practice location

Address: 6490 Excelsior Blvd STE W200, St Louis Park, MN 55426-4705
Phone: (952) 993-3180
Mailing address: 6465 Wayzata Blvd STE 210, St Louis Park, MN 55426-1728

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 1045 (MN)

Other Physician Assistant providers in Minnesota →

Registry record

NPI: 1023206935
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Oct 2007
Record last updated: 5 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.