Individual
MELINDA M JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8063
(860) 679-2689
(860) 679-1754
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-8082
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
007626
CT
363AS0400X
Surgical Physician Assistant
50.001122
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0069367
—
OH
Enumeration date
07/27/2012
Last updated
03/20/2026
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