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General NPI Number Information
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NPI Number | 1134612500
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Entity Type | Individual
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Provider Name | JILL JOHNSTON AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/11/2018
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 1418 S TACOMA ST
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City | SPOKANE
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State | WA
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Zip | 99203
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Country | US
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Telephone | 949-295-4069
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Fax |
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Provider Business Mailing Address
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Address Line | 20151 SW BIRCH ST STE 100
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-1794
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Country | US
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Telephone | 949-270-2100
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Fax | 949-650-4458
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP60863423
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP60863423
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP60863423
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License Number State | WA
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