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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. ICEPHINE BALLARD JOHNSON NURSE PRACTITIONER
NPI 1568430346
Nurse Practitioner - Adult Health in Saint Cloud, MN

Active since March 09, 2006
720 4TH AVE S, SAINT CLOUD, MN 56301(320) 308-4861(320) 308-3192 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jul 13, 2026, Sep 6, 2023, Jul 21, 2022 (3 updates tracked since 2022).

About Mrs. Icephine Ballard Johnson Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ICEPHINE BALLARD JOHNSON NURSE PRACTITIONER (NPI 1568430346) is an individual adult health provider in Saint Cloud, Minnesota, licensed in Minnesota (R 107237-0) and active in the NPI registry since March 2006.

NPPES Registry Identity

NPI1568430346
Entity TypeIndividualFemale
Primary Taxonomy363LA2200X
Provider Legal NameMRS. ICEPHINE BALLARD JOHNSONCredential: NURSE PRACTITIONER
Location Address720 4TH AVE SSaint Cloud, MN 56301-4442
Mailing Address720 4th Ave SSaint Cloud, MN 56301-4442 · (320) 308-4861 · Fax (320) 308-3192
Phone(320) 308-4861
Fax(320) 308-3192
Sole ProprietorNo
Enumeration DateMarch 9, 2006
Last NPPES UpdateJuly 13, 20263 updates tracked since enumeration
✔ NPI 1568430346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in MN · R 107237-0
720 4TH AVE S, Saint Cloud, MN 56301
Open in Google Maps ↗

Other Identifiers 1

Other41687554MN · Ein

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHELE R TRAUB PHD, BCBA-D
Behavior Analyst
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (320) 308-2043
DR. BRENT NIELSEN MD
Family Medicine
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (320) 308-3191
DR. HOLLY KRISTINE LEVINE MD
Family Medicine
720 4TH AVE S, STUDENT HEALTH SERVICE
SAINT CLOUD, MN 56301
Stearns County (320) 308-4856
NICOLETTE SCHAEFGES
Specialist/Technologist (Athletic Trainer)
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (608) 785-8000
KRISTINA M GROSS RN, CNP
Nurse Practitioner (Family)
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (320) 308-3193
MR. JEFFREY TODD JOHNSON ATC
Specialist/Technologist (Athletic Trainer)
720 4TH AVE S, 214 HALENBECK HALL
SAINT CLOUD, MN 56301
Stearns County (320) 308-2503
MS. JENNIFER KAY ROCHELEAU DORHOLT PSYD, LP
Psychologist (Clinical)
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (320) 308-3171
MARY HELEN ANDREOTTI RN CNP
Nurse Practitioner (Adult Health)
720 4TH AVE S
SAINT CLOUD, MN 56301
Stearns County (320) 308-3191

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Icephine Johnson's NPI number?

The NPI number for Icephine Johnson is 1568430346. It was assigned to this individual provider in the NPPES registry on March 9, 2006.

Where is Icephine Johnson located?

Icephine Johnson practices at 720 4th Ave S, Saint Cloud, MN 56301. The listed phone number is (320) 308-4861.

What is Icephine Johnson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

When was this NPI record last updated?

The NPPES record for Icephine Johnson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 38 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.