Individual
MONA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
324 DUNES PLZ, MICHIGAN CITY, IN 46360-7342
(219) 872-7215
Mailing address
19265 KERN RD, SOUTH BEND, IN 46614-5720
(574) 231-8220
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
28074373A
IN
Other
Enumeration date
04/09/2007
Last updated
07/08/2007
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