Provider Demographics
NPI:1992964324
Name:JOHNSTON, PAULA L
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:L
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2670 ROBINDALE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-1654
Mailing Address - Country:US
Mailing Address - Phone:330-784-6850
Mailing Address - Fax:330-784-6850
Practice Address - Street 1:2670 ROBINDALE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-1654
Practice Address - Country:US
Practice Address - Phone:330-784-6850
Practice Address - Fax:330-784-6850
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2008-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2736892Medicaid