Individual
MS. KELLY LYNN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
4420 DIXIE HWY STE 126, LOUISVILLE, KY 40216-2994
(502) 810-3780
(502) 394-3607
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3013074
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300051663
—
IN
05
—
7100576210
—
KY
Enumeration date
01/25/2019
Last updated
08/30/2024
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