1306074299 NPI number — MR. AARON ROSS JOHNSTON FNP

Table of content: MR. AARON ROSS JOHNSTON FNP (NPI 1306074299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306074299 NPI number — MR. AARON ROSS JOHNSTON FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSTON
Provider First Name:
AARON
Provider Middle Name:
ROSS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306074299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
650 JOEL DR.
Provider Second Line Business Mailing Address:
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Provider Business Mailing Address City Name:
FT. CAMPBELL
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42223-5349
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-798-8130
Provider Business Mailing Address Fax Number:
270-956-0180

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 JOEL DR.
Provider Second Line Business Practice Location Address:
BLANCHFIELD ARMY COMMUNITY HOSPITAL
Provider Business Practice Location Address City Name:
FT. CAMPBELL
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42223-5349
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-798-8130
Provider Business Practice Location Address Fax Number:
270-956-0180
Provider Enumeration Date:
06/30/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  RN1901129 , registered in the state of GA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: APN000017882 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: VAD000 . This is a "VAD000" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".