Healthcare Provider Details

I. General information

NPI: 1851202196
Provider Name (Legal Business Name): MEGAN JOHNSTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1102 LOGAN AVE
CHEYENNE WY
82001-5250
US

IV. Provider business mailing address

2514 WINDMILL RD
CHEYENNE WY
82009-5272
US

V. Phone/Fax

Practice location:
  • Phone: 307-630-7522
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: