Individual
KAYLA RENEE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
755 W CARMEL DR STE 101, CARMEL, IN 46032-5875
(317) 846-2396
(317) 846-1699
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
02657
WV
363A00000X
Physician Assistant
Primary
10002926A
IN
Other
Enumeration date
09/02/2014
Last updated
09/20/2021
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