Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacy L Johnson, NP

Individual provider Nurse Practitioner · NPI 1417907189

Stacy L Johnson, NP is a Nurse Practitioner in Fort Wayne, Indiana. Qualified in 2006, 20 years ago. Practices with Iu Health Medical Group, LLC, a 4,351-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
20
Licensed in
IN
In the registry since
2006
Specialties on file
2
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2510 E Dupont Rd Ste 226
Fort Wayne, IN 46825-1603
Phone: (260) 460-3100
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71002173A (IN)
Nurse Practitioner Taxonomy 363L00000X · Licence 28140959A (IN)

Record details

NPI number1417907189
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedMay 11, 2006
Last updated in NPPESNovember 20, 2023
Certification dateNovember 20, 2023
Mailing address250 N Shadeland Ave, Indianapolis, IN 46219-4959

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2006 (20 years in practice)
Group practice Iu Health Medical Group, Llc — 4351 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Fort Wayne