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Individual

MRS. KANDACE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
5189 W 600 N, MCCORDSVILLE, IN 46055-9715
(317) 329-7232
Mailing address
13639 CREEKRIDGE LN, FISHERS, IN 46055-9599
(317) 690-2577

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
71007867A
IN
363LG0600X
Gerontology Nurse Practitioner
71007867A
IN

Other

Enumeration date
09/22/2011
Last updated
11/04/2020
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