Individual
CARMEN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1500 PROVIDENT DR STE A, WARSAW, IN 46580-3297
(574) 372-7637
Mailing address
315 W OLD KEY DR, PERU, IN 46970-9057
(765) 475-6963
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001237A
IN
Other
Enumeration date
04/09/2012
Last updated
09/14/2020
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