Individual
MICHAEL L JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 886-7431
(660) 886-9001
Mailing address
2305 SOUTH 65 HIGHWAY, MARSHALL, MO 65340-3702
(660) 868-7431
(660) 886-9001
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
096914
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010568509
—
MO
01
—
33415014
BCBS
—
01
—
33415034
BCBS
—
05
—
429090905
—
MO
05
—
540568508
—
MO
05
—
595956202
—
MO
Enumeration date
04/24/2006
Last updated
08/11/2015
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