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JEREL D JOHNSON, ABOC OPTICIAN – NPI #1750421160
Optician

NPI Profile for JEREL D JOHNSON in COOK, MN.

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Contact Information

JEREL D JOHNSON, ABOC OPTICIAN
23 EAST VERMILION AVE
COOK, MN  55723-0127
 Phone: 218-666-2879
 Fax:
 Website:
 

Specialty

 Taxonomy Code Specialty Code Provider Type

Optician

 156FX1800X 96[5] Optician
Indicates primary specialty

NPI Profile & details for JEREL D JOHNSON · (Male)

NPI Number 1750421160
Status Active
Credentials ABOC OPTICIAN
Entity Individual
Enumeration date 02/07/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 19618
  • MN Other 66791CO 1ST PLAN BLUE
  • MN Other 66791CO BCBS
  • MN Other 2100594 MEDICA
  • MN Other 110191 UCARE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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