Individual
TRACY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321-2901
(219) 703-1141
Mailing address
7537 MAGNOLIA AVE, HAMMOND, IN 46324-3126
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CNA1002493
IN
Other
Enumeration date
08/01/2023
Last updated
08/16/2023
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