Individual
CORIONNA JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4759 NORMAL AVE, INDIANAPOLIS, IN 46226-2915
(317) 744-3758
Mailing address
4759 NORMAL AVE, INDIANAPOLIS, IN 46226-2915
(317) 744-3758
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
23-016415-1
IN
3747P1801X
Personal Care Attendant
Primary
23-016415-1
IN
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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