Provider Demographics
NPI:1104060706
Name:BUEHLER-JOHNSTON, BILLIE JEAN (RN)
Entity type:Individual
Prefix:
First Name:BILLIE
Middle Name:JEAN
Last Name:BUEHLER-JOHNSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2327 E FRANKLIN AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55406-1795
Mailing Address - Country:US
Mailing Address - Phone:612-872-1950
Mailing Address - Fax:612-872-1788
Practice Address - Street 1:2327 E FRANKLIN AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1795
Practice Address - Country:US
Practice Address - Phone:612-872-1950
Practice Address - Fax:612-872-1788
Is Sole Proprietor?:No
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 179171-63747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1902070584Medicaid