Individual
MRS. PAULA ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8177 CLEARVISTA PKWY, INDIANAPOLIS, IN 46256-1662
(317) 621-7801
(317) 621-7205
Mailing address
65 AIRPORT PKWY, STE 114, GREENWOOD, IN 46143-1439
(317) 807-0268
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001130
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P01009924
RR MEDICARE PTAN
IN
Enumeration date
08/31/2006
Last updated
11/11/2021
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