Individual
ANGELA KIRSTEN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2243 E 17TH ST, IDAHO FALLS, ID 83404-6519
(208) 851-2381
Mailing address
422 CHESAPEAKE AVE, CHUBBUCK, ID 83202-1674
(208) 851-2381
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
65180
ID
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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