Individual
CAITLIN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
855 N WESTHAVEN DR, OSHKOSH, WI 54904-7668
(920) 303-8700
(920) 456-7601
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085005500
IL
363A00000X
Physician Assistant
Primary
7674
WI
363A00000X
Physician Assistant
PA181482
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100260949
—
WI
01
—
PA181482
OREGON MEDICAL BOARD LICENSE
OR
Enumeration date
06/26/2015
Last updated
01/25/2024
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