Individual
MS. CRYSTAL IVY JOHSTONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, FNP-C, RN
Contact information
Practice address
400 CHARTER BLVD, MACON, GA 31210-4831
(478) 757-6000
(478) 757-6007
Mailing address
400 CHARTER BLVD, MACON, GA 31210-4831
(478) 757-6000
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN088169
GA
Other
Enumeration date
09/15/2022
Last updated
03/20/2025
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