Individual
JOHNA ANN RADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
710 PARK PL, MISHAWAKA, IN 46545-3519
(574) 273-6767
(574) 968-7160
Mailing address
PO BOX 5909, PORTLAND, OR 97228-5909
(574) 273-6767
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28147796A
IN
Other
Enumeration date
10/25/2019
Last updated
04/02/2020
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