Individual
KEVIN W JOHNSTON
Active
Individual
KEVIN W JOHNSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
689209
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F309196
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F309196
NY STATE OFFICE OF PROFESSIONS
NY
Enumeration date
12/04/2014
Last updated
12/03/2019
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