Provider Demographics
NPI:1427158674
Name:JOHNSTON, JOAN KATHRYN (FNP)
Entity type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:KATHRYN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:95 BRUCE DR
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:MA
Mailing Address - Zip Code:01226-1020
Mailing Address - Country:US
Mailing Address - Phone:413-684-8916
Mailing Address - Fax:413-684-4443
Practice Address - Street 1:165 TOR CT
Practice Address - Street 2:BERKSHIRE MEDICAL CENTER HILLCREST CAMPUS
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-3001
Practice Address - Country:US
Practice Address - Phone:413-445-9243
Practice Address - Fax:413-445-9326
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA109903363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
E03093Medicare UPIN