Stacy L Johnson in Fort Wayne - Nurse Practitioner
Stacy L Johnson - NPI 1417907189
Stacy L Johnson is a Nurse Practitioner in Fort Wayne, Indiana. Stacy L Johnson practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Stacy L Johnson is 1417907189. The last update date is 2023-11-20.
Stacy L Johnson's current location address is 2510 E Dupont Rd Ste 226, Fort Wayne, Indiana. You can contact this provider via phone number 2604603100. The mailing address for Stacy L Johnson is 2510 E Dupont Rd Ste 226, Fort Wayne, Indiana. To know further, please read the information below!
Provider Profile Detail
Provider Name | Stacy L Johnson |
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Address | 2510 E Dupont Rd Ste 226, Fort Wayne, Indiana |
Phone Number | 2604603100 |
Fax Number | |
Sole Proprietor | N |
Credentials | NP |
NPI Number Detail
NPI Number | 1417907189 |
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Provider Enumeration Date | 2006-05-11 |
Last Updated Date | 2023-11-20 |
Provider Mailing Address Detail
Address | 2510 E Dupont Rd Ste 226 |
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City | Fort Wayne |
State | Indiana (IN) |
Post Code | 4682516030 |
Phone Number | 2604603100 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Nurse Practitioner |
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Taxonomy | 363L00000X |
Licence No | 28140959A |
Definition: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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200846660 | IN | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Stacy L Johnson by the Centers for Medicare & Medicaid Services?
The Stacy L Johnson has been assigned the NPI (National Provider Identifier) 1417907189. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical location address where Stacy L Johnson's facilities are situated?
The facilities of Stacy L Johnson are physically located at the following address: 2510 E Dupont Rd Ste 226, Fort Wayne, IN, 4682516030.
What is Stacy L Johnson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Stacy L Johnson's specialized field of practice is Nurse Practitioner, and the corresponding taxonomy code that categorizes this area of specialization is 363L00000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1417907189 to Stacy L Johnson?
The Centers for Medicare & Medicaid Services assigned the 1417907189 to Stacy L Johnson on 2006-05-11.
When was the information pertaining to Stacy L Johnson most recently updated or revised?
The details related to Stacy L Johnson, including its address, specialty, and other relevant information, were last updated or revised on 2023-11-20.