Healthcare Provider Details

I. General information

NPI: 1518890730
Provider Name (Legal Business Name): KELLY D JOHNSTON-MESSENGER PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY JOHNSTON

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/06/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3555 S VAL VISTA DR
GILBERT AZ
85297-7323
US

IV. Provider business mailing address

929 N VAL VISTA DR STE 109
GILBERT AZ
85234-3701
US

V. Phone/Fax

Practice location:
  • Phone: 480-234-6124
  • Fax:
Mailing address:
  • Phone: 480-234-6124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number340470
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: