Ann Johnson, OTR/L
Individual provider Active NPI Occupational Therapist · Backus, MN
NPI 1255424701 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1255424701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 101774 (MN)
- Practice address
- 1615 State 84 NW
Backus, MN 56435 - Phone
- (218) 682-3955
- NPI assigned
- Oct 2, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 101774 | MN | MD | Family Medicine Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 101774 | MN | Yes |
Addresses
Primary practice location
1615 State 84 NW
Backus, MN 56435
Mailing address
1615 State 84 NW
Backus, MN 56435
Phone (218) 682-3955
Other providers in Backus, MN
All providers in Backus, MN · Occupational Therapist in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.