Individual
SHANNON JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
675 JUSTICE WAY RM C0049, INDIANAPOLIS, IN 46203-1574
(877) 465-6650
(804) 294-2775
Mailing address
12034 VILLA DORADO DR, SAINT LOUIS, MO 63146-4747
(314) 692-0703
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2014021871
MO
363L00000X
Nurse Practitioner
209.012733
IL
363L00000X
Nurse Practitioner
Primary
71015147A
IN
363LF0000X
Family Nurse Practitioner
2014021871
MO
363LF0000X
Family Nurse Practitioner
209.012733
IL
Other
Enumeration date
07/02/2014
Last updated
07/31/2025
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