Individual
MARTHA STACY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
702 W ALTO RD, KOKOMO, IN 46902-4907
(317) 876-3699
Mailing address
702 W ALTO RD, KOKOMO, IN 46902-4907
(317) 876-3699
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71015636A
IN
Other
Enumeration date
07/27/2024
Last updated
10/17/2024
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