Individual
MS. MARY LYNN JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
800 HOWARD AVE, YPB 4TH FLOOR, NEW HAVEN, CT 06519-1369
(203) 785-4191
(203) 737-6014
Mailing address
300 GEORGE ST, 6TH FLOOR, NEW HAVEN, CT 06511-6624
(203) 785-4216
(203) 737-6014
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
002311
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008003990
—
CT
Enumeration date
05/06/2009
Last updated
01/23/2013
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