1427158674 NPI number — MRS. JOAN KATHRYN JOHNSTON FNP

Table of content: MRS. JOAN KATHRYN JOHNSTON FNP (NPI 1427158674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427158674 NPI number — MRS. JOAN KATHRYN JOHNSTON FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSTON
Provider First Name:
JOAN
Provider Middle Name:
KATHRYN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

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:
1427158674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 BRUCE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01226-1020
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-684-8916
Provider Business Mailing Address Fax Number:
413-684-4443

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
165 TOR CT
Provider Second Line Business Practice Location Address:
BERKSHIRE MEDICAL CENTER HILLCREST CAMPUS
Provider Business Practice Location Address City Name:
PITTSFIELD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01201-3001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-445-9243
Provider Business Practice Location Address Fax Number:
413-445-9326
Provider Enumeration Date:
09/25/2006

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: 363L00000X , with the licence number:  109903 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , with the licence number: 109903 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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