MS. JACQUELYN LEE JOHNSON C.N.P. NPI 1891710984

NPI Information

  • NPI: 1891710984
  • Provider Name: MS. JACQUELYN LEE JOHNSON, C.N.P.
  • Classification: Nurse Practitioner - 363L00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 811 2ND ST SE
    SUITE A
    LITTLE FALLS, MN
    ZIP 56345
  • Phone: (320) 631-7000

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NPI Details

MS. Jacquelyn Lee Johnson, C.N.P. is a nurse practitioner in Little Falls, MN. The provider is (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. MS. Jacquelyn Lee Johnson, C.N.P. NPI is 1891710984. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

811 2ND ST SE
SUITE A
LITTLE FALLS, MN
ZIP 56345-559
Phone: (320) 631-7000
Fax: (320) 632-0534

The NPI 1891710984 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/12/2006 and was last updated on 2/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerR108719-0MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1500019836MEDICARE OSCAR/CERTIFICATIONMINNESOTA
20107328OTHERMEDICA
3500001748MEDICARE OSCAR/CERTIFICATIONMINNESOTA
447G13JOOTHERMINNESOTABCBS OF MINNESOTA
5P37494MEDICARE UPIN
6140376C736OTHERMINNESOTAUCARE MINNESOTA
7A024OTHERMINNESOTATRICARE
8HP33899OTHERHEALTH PARTNERS
9NA9231028468OTHERPREFERRED ONE
10044997100MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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