Healthcare Provider Details

I. General information

NPI: 1831189554
Provider Name (Legal Business Name): STEFANI JOHNSTON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 N ILLINOIS ST
INDIANAPOLIS IN
46204-1904
US

IV. Provider business mailing address

201 N ILLINOIS ST
INDIANAPOLIS IN
46204-1904
US

V. Phone/Fax

Practice location:
  • Phone: 260-705-8544
  • Fax:
Mailing address:
  • Phone: 260-705-8544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71000852A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28113743A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: