Kandace Faye Johnson, D.C.
Individual provider Active NPI Chiropractor · Victoria, MN
NPI 1831284587 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1831284587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 4834 (MN)
- Practice address
- 7924 Victoria Drive
Suite 202
Victoria, MN 55386-0156 - Phone
- (952) 448-9000
- Fax
- (952) 448-4901
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4834 | MN | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4834 | MN | Yes |
Addresses
Primary practice location
7924 Victoria Drive
Suite 202
Victoria, MN 55386-0156
Mailing address
7924 Victoria Drive
Suite 202
Victoria, MN 55386
Phone (952) 448-9000
Other providers in Victoria, MN
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.