Individual
MS. BONNIE E JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
11700 STUDT AVE, SAINT LOUIS, MO 63141-7031
(314) 989-1181
(314) 989-1441
Mailing address
11700 STUDT AVE, SAINT LOUIS, MO 63141-7031
(314) 989-1181
(314) 989-1441
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2012016906
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1487106399
—
MO
05
—
ENROLLED
—
IL
Enumeration date
10/26/2016
Last updated
11/12/2018
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