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Individual

STEFANI JOHNSTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
12219 DRIFTWOOD PT, FORT WAYNE, IN 46845-6912
(260) 705-8544
Mailing address
12219 DRIFTWOOD PT, FORT WAYNE, IN 46845-6912
(260) 705-8544

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28113743A
IN
363L00000X
Nurse Practitioner
Primary
71000852A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200338290
IN
Enumeration date
10/25/2005
Last updated
03/05/2026
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