Provider Demographics
NPI:1285690933
Name:JOHNSTON, LINDA L (CNP, CNM)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:L
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:CNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 VAUGHN RD
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-3215
Mailing Address - Country:US
Mailing Address - Phone:518-566-9452
Mailing Address - Fax:518-562-7189
Practice Address - Street 1:206 CORNELIA ST
Practice Address - Street 2:SUITE 306
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-2779
Practice Address - Country:US
Practice Address - Phone:518-566-9452
Practice Address - Fax:518-562-7189
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000944176B00000X
NY360418176B00000X
176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02123137Medicaid
NYMJ0614417OtherDEA
NYP26375Medicare UPIN