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General NPI Number Information
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NPI Number | 1174237705
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Entity Type | Individual
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Provider Name | DAVID P JOHNSON FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/09/2023
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 540 HOSPITAL DR
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City | WINAMAC
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State | IN
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Zip | 46996-1173
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Country | US
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Telephone | 574-946-2194
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Fax | 546-946-2143
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Provider Business Mailing Address
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Address Line | 10229 CARRIAGE CT
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City | PLYMOUTH
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State | IN
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Zip | 46563-9191
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Country | US
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Telephone | 574-936-1916
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71013448A
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License Number State | IN
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