Healthcare Provider Details

I. General information

NPI: 1992565303
Provider Name (Legal Business Name): LINDA JOHNSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 NATCHEZ TRACE AVE STE 205
BOWLING GREEN KY
42103-7947
US

IV. Provider business mailing address

PO BOX 21890
BELFAST ME
04915-4115
US

V. Phone/Fax

Practice location:
  • Phone: 270-745-7246
  • Fax: 270-282-2027
Mailing address:
  • Phone: 502-907-0356
  • Fax: 502-919-9780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number4017486
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4017486
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number4017486
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: