Individual
CORETTA Y JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED NURSE
Contact information
Practice address
6226 LA PAS TRL, INDIANAPOLIS, IN 46268-2509
(317) 504-4924
Mailing address
6226 LA PAS TRL, INDIANAPOLIS, IN 46268-2509
(317) 504-4924
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
28195918A
IN
Other
Enumeration date
10/16/2023
Last updated
04/27/2024
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