Individual
ZACHARY T JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1801 N SENATE BLVD STE 635, INDIANAPOLIS, IN 46202-1212
(317) 962-3235
(317) 962-3916
Mailing address
1801 N SENATE BLVD STE 635, INDIANAPOLIS, IN 46202-1212
(317) 962-3235
(317) 962-3916
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
71011255A
IN
363LG0600X
Gerontology Nurse Practitioner
71011255A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001587133
ANTHEM PTAN
IN
05
—
300054456
—
IN
Enumeration date
07/23/2021
Last updated
02/12/2025
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