Individual
KATELYN MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7150 CLEARVISTA DR, INDIANAPOLIS, IN 46256-1695
(317) 621-6262
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002632A
IN
Other
Enumeration date
10/19/2018
Last updated
07/18/2025
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