Individual provider · Type 1 NPI

Brandon Lee Johnson, FNP-C

Nurse Practitioner · Fort Wayne, IN

NPI number 1417358482 Active

Practice location

1818 Carew St Ste 120
Fort Wayne, IN 46805-4764

Call (260) 425-6200 Map

Fax (260) 425-6205

Mailing address

341 Ponce De Leon Ave NE
Atlanta, GA 30308-2012

Specialties and licenses

Taxonomy	Code	License
Nurse Practitioner Primary	363L00000X	71018116A (IN)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1417358482

Brandon Lee Johnson, FNP-C's National Provider Identifier is 1417358482, issued on Sep 10, 2014. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Fort Wayne, IN. The record was last updated on Jul 24, 2026.