Individual
ABIGAIL ANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A.
Contact information
Practice address
303 S NAPPANEE ST, ELKHART, IN 46514-2066
(574) 296-3200
(574) 296-3392
Mailing address
PO BOX 2968, ELKHART, IN 46515-2968
(574) 296-3200
(574) 296-3392
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
1601000628
MI
231H00000X
Audiologist
Primary
23002329A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201080690
—
IN
01
—
23002329A
STATE LICENSE
IN
Enumeration date
10/22/2012
Last updated
10/06/2015
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