Individual
CARLIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2326 18TH ST STE 210, COLUMBUS, IN 47201-5362
(812) 378-4511
Mailing address
PO BOX 775383, CHICAGO, IL 60677-5383
(812) 376-5315
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28202334A
IN
363LF0000X
Family Nurse Practitioner
Primary
71006155A
IN
Other
Enumeration date
03/23/2016
Last updated
09/09/2024
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