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Organization

KK NP IN ADULT HEALTH LLP

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRIS JOHNSTON NP (PROVIDER)
(631) 675-9000
Entity
Organization

Contact information

Practice address
635 BELLE TERRE RD STE 103, PORT JEFFERSON, NY 11777-1987
(631) 675-9000
(631) 675-9002
Mailing address
635 BELLE TERRE RD STE 103, PORT JEFFERSON, NY 11777-1987
(631) 675-9000
(631) 675-9002

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
363L00000X
Nurse Practitioner
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457550907
NPI
Enumeration date
04/21/2021
Last updated
04/18/2023
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