STACY L JOHNSON

FORT WAYNE, IN
NPI1417907189
Former NameSTACY L SIBLE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: IN  71002173A)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: IN  28140959A)
Enumeration Date2006-05-11
Last Update Date2023-11-20
Business Address
STACY L JOHNSON NP
2510 E DUPONT RD STE 226
FORT WAYNE, IN 46825-1603
Phone number: 260-460-3100
Mailing Address
STACY L JOHNSON NP
250 N SHADELAND AVE
INDIANAPOLIS, IN 46219-4959
Phone number: