Healthcare Provider Details

I. General information

NPI: 1700183589
Provider Name (Legal Business Name): LINDSAY ANNE JOHNSTON PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2011
Last Update Date: 08/18/2023
Certification Date: 08/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N. FIRST STREET, BLDG 46
ALTUS AFB OK
73523-5005
US

IV. Provider business mailing address

301 N. FIRST STREET, BLDG 46
ALTUS AFB OK
73523-5004
US

V. Phone/Fax

Practice location:
  • Phone: 580-481-5244
  • Fax:
Mailing address:
  • Phone: 580-481-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: