Individual
STEPHANIE KRYSTIE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
720 ESKENAZI AVE, INDIANAPOLIS, IN 46202-5187
(317) 880-7666
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71014713A
IN
363LG0600X
Gerontology Nurse Practitioner
28225777A
IN
Other
Enumeration date
11/17/2023
Last updated
03/16/2026
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