Individual
SUSAN DWYER JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1001 W 10TH ST, INDIANAPOLIS, IN 46202-2859
(317) 630-7243
Mailing address
8910 PURDUE RD, STE.500, INDIANAPOLIS, IN 46268-6100
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71002617A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000585282
ANTHEM
IN
05
—
200509970
—
IN
Enumeration date
03/09/2007
Last updated
11/20/2008
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