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NPI Code Detail

MEDICARE: TIFFANY LYNN JOHNSON FNP-C

MEDICARE: TIFFANY LYNN JOHNSON FNP-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner71006292AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033577457
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIFFANY LYNN JOHNSON FNP-C
Provider Business Mailing Address
First Line : 1100 SOUTHFIELD DR STE 1370
Second Line :
City : PLAINFIELD
State : IN
Zip : 46168-4300
Country : US
Telephone Number : 317-837-5566
Fax Number : 317-837-5567
Provider Business Practice Location Address
First Line : 100 HOSPITAL LN STE 225
Second Line :
City : DANVILLE
State : IN
Zip : 46122-1870
Country : US
Telephone Number : 317-718-4730
Fax Number : 317-718-4733
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2016
Last Update Date : 01/09/2026

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