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General NPI Number Information
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NPI Number | 1962591537
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Entity Type | Organization
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Legal Business Name | JOHNSON FAMILY HEALTH CARE
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 313 S MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4023
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Country | US
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Telephone | 219-661-3013
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Fax | 219-661-3051
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Provider Business Mailing Address
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Address Line | 313 S MAIN ST
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City | CROWN POINT
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State | IN
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Zip | 46307-4023
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Country | US
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Telephone | 219-661-3013
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Fax | 219-661-3051
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KAREN MICHELLE JOHNSON
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Credential | APRN, FNP,MS, BC
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Telephone | 219-661-3013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 71000253A
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License Number State | IN
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