Individual
STEPHANIE M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3900 KRESGE WAY STE 56, LOUISVILLE, KY 40207-4683
(502) 895-7265
(502) 897-2032
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3006615
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100136300
—
KY
Enumeration date
08/31/2010
Last updated
03/17/2018
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