Individual
MR. TIMOTHY JOHN JOHNSTON
Active
Individual
MR. TIMOTHY JOHN JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
19063
MT
367500000X
Certified Registered Nurse Anesthetist
55450
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145254
BCBS OF KS
KS
05
—
200372610A
—
KS
Enumeration date
05/17/2006
Last updated
04/22/2025
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