Healthcare Provider Details

I. General information

NPI: 1811392483
Provider Name (Legal Business Name): SUZANNE ELIZABETH JOHANNIGMAN FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2014
Last Update Date: 11/14/2025
Certification Date: 11/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 SIX PINE RANCH RD
BATESVILLE IN
47006-1399
US

IV. Provider business mailing address

PO BOX 236
BATESVILLE IN
47006-0236
US

V. Phone/Fax

Practice location:
  • Phone: 812-934-5252
  • Fax: 812-932-0721
Mailing address:
  • Phone: 812-933-5441
  • Fax: 812-933-3766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005204A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005204B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: