Individual
NIYA JOHNIQUE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4240 N SHADELAND AVE APT 3, INDIANAPOLIS, IN 46226-3733
(317) 833-0973
Mailing address
4240 N SHADELAND AVE APT 3, INDIANAPOLIS, IN 46226-3733
(317) 833-0973
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
23-016381-1
IN
Other
Enumeration date
10/12/2023
Last updated
10/12/2023
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