Individual
ALLIE SUZANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
1002 WISHARD BLVD, INDIANAPOLIS, IN 46202-4163
(317) 944-4846
Mailing address
PO BOX 778912, CHICAGO, IL 60677-8912
(317) 777-6435
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28217178A
IN
363LF0000X
Family Nurse Practitioner
71005922A
IN
Other
Enumeration date
08/12/2019
Last updated
04/18/2024
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