Healthcare Provider Details

I. General information

NPI: 1861076382
Provider Name (Legal Business Name): LAURA JOHNSTAD DNP, FNP-C, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2021
Last Update Date: 03/11/2025
Certification Date: 03/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57950 LEAVENWORTH ST
MCCONNELL AFB KS
67221-3505
US

IV. Provider business mailing address

57950 LEAVENWORTH ST
MCCONNELL AFB KS
67221-3505
US

V. Phone/Fax

Practice location:
  • Phone: 316-759-5049
  • Fax:
Mailing address:
  • Phone: 316-759-5049
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number83403
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number83403
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: