NPI 1255564522

Brian L Johnson, QMA

Practitioner Technician Fort Wayne, IN

Practice location

Address: 909 E State Blvd, Fort Wayne, IN 46805-3404
Phone: (260) 481-2700
Fax: (260) 481-2709

Registered specialties

Technician Primary

Nursing Service Related Providers Taxonomy 374700000X

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Registry record

NPI: 1255564522
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Sep 2009
Record last updated: 2 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.