Individual
MATTHEW PHILIP JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1178 KINOOLE ST, HILO, HI 96720-7206
(083) 338-3600
Mailing address
75-5751 KUAKINI HWY STE 203, KAILUA KONA, HI 96740-1753
(808) 333-3600
(808) 961-5167
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3007618
KY
363LP2300X
Primary Care Nurse Practitioner
Primary
3540
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000781639
BCBS WALMART MILLE
KY
01
—
000000781754
BCBS TROVER
KY
01
—
3540
APRN LICENSE
HI
05
—
7100215240
—
KY
01
—
P01105256
RR MEDICARE-BAPTIST HEALTH MADISONVILLE INC
KY
Enumeration date
06/19/2012
Last updated
07/18/2022
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