Provider Demographics
NPI:1407699556
Name:JOHNSTON, JEANINE HELEN (DOULA)
Entity type:Individual
Prefix:
First Name:JEANINE
Middle Name:HELEN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 JUTEN DR
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55803-9746
Mailing Address - Country:US
Mailing Address - Phone:218-310-9637
Mailing Address - Fax:
Practice Address - Street 1:3512 JUTEN DR
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55803-9746
Practice Address - Country:US
Practice Address - Phone:218-310-9637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula