Stacy L Johnson is a Family in Fort Wayne, Indiana. Stacy L Johnson practices all healthcare services and medical treatments related to Family. 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 2006-05-11 |
| Last Updated Date | 2023-11-20 |
Provider Mailing Address Detail
| Address | 2510 E Dupont Rd Ste 226 |
|---|---|
| City | Fort Wayne |
| State | Indiana (IN) |
| Post Code | 4682516030 |
| Phone Number | 2604603100 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family |
|---|---|
| Taxonomy | 363Lf0000X |
| Licence No | 71002173A |
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Definition: An advanced practice registered nurse expert in primary healthcare for patients of all ages. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 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 Family, and the corresponding taxonomy code that categorizes this area of specialization is 363Lf0000X.
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.