Charlene Johnson, RN

Individual provider Active NPI Emergency Registered Nurse · Fargo, ND

NPI 1962227892 · NPPES record last updated Nov 16, 2024

Key facts

NPI
1962227892
Entity type
Individual (NPI type 1)
Primary specialty
Emergency Registered Nurse 163WE0003X
License
R41835 (ND)
Practice address
2101 Elm St N
Fargo, ND 58102-2417
Phone
(701) 237-2611
NPI assigned
Nov 16, 2024
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
2459535MNMDEmergency Registered Nurse
R41835NDMDEmergency Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X 2459535 MN
Emergency Registered Nurse 163WE0003X R41835 ND Yes

Addresses

Primary practice location

2101 Elm St N
Fargo, ND 58102-2417

Mailing address

2101 Elm St N
Fargo, ND 58102-2417
Phone (701) 237-2611

Other providers in Fargo, ND

All providers in Fargo, ND · Emergency Registered Nurse in North Dakota

Sources for this page

Verify at the official NPI Registry.