Individual
KAITLYN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
510 S. WASHINGTON ST, BASTROP, LA 71220-4043
(318) 556-3333
(318) 450-3576
Mailing address
510 S. WASHINGTON ST, BASTROP, LA 71220-4043
(318) 556-3333
(318) 450-3576
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
207579
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207579
CERTIFIED NURSE PRACTITIONER
LA
Enumeration date
10/01/2019
Last updated
10/01/2019
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