Provider Demographics
NPI:1285060996
Name:JOHNSTON, NANCY FAIRCLOTH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:FAIRCLOTH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 TOMAHAWK TRL
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NC
Mailing Address - Zip Code:28328-3053
Mailing Address - Country:US
Mailing Address - Phone:910-596-8793
Mailing Address - Fax:
Practice Address - Street 1:507 COLLEGE ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-4011
Practice Address - Country:US
Practice Address - Phone:910-592-1538
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist