Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mrs. Icephine Ballard Johnson, NURSEPRACTITIONER

Individual provider Adult Health Nurse Practitioner · NPI 1568430346

Mrs. Icephine Ballard Johnson, NURSEPRACTITIONER is an Adult Health Nurse Practitioner in Saint Cloud, Minnesota. Licensed in Minnesota. Registered with an NPI since 2006.

Licensed in
MN
In the registry since
2006

Practice location Address checks out

720 4th Ave S
Saint Cloud, MN 56301-4442
Phone: (320) 308-4861
Fax: (320) 308-3192
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence R 107237-0 (MN)

Record details

NPI number1568430346
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedMarch 9, 2006
Last updated in NPPESJuly 13, 2026

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