Provider Demographics
NPI:1093512725
Name:JOHNSTON, ROSIE PEARL
Entity type:Individual
Prefix:
First Name:ROSIE
Middle Name:PEARL
Last Name:JOHNSTON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 835
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:WV
Mailing Address - Zip Code:25043-0835
Mailing Address - Country:US
Mailing Address - Phone:304-587-9992
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 835
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043-0835
Practice Address - Country:US
Practice Address - Phone:304-587-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant