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Individual

MRS. CANDY SUE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN

Contact information

Practice address
6940 MICHIGAN RD, INDIANAPOLIS, IN 46268-2800
(317) 221-3461
Mailing address
PO BOX 637764, CINCINNATI, OH 45263-7764
(317) 880-3939

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-007187
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7200613
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/05/2008
Last updated
09/22/2025
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