Individual
MS. HEATHER ELIZABETH JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP-BC
Contact information
Practice address
505 S NOLEN DR, SOUTHLAKE, TX 76092-9167
(817) 424-1525
(817) 424-3491
Mailing address
PO BOX 35629, DALLAS, TX 75235-0629
(214) 424-2213
(214) 231-2159
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
752355
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
752355
CRNA LICENSE
TX
Enumeration date
12/04/2012
Last updated
05/23/2013
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