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General NPI Number Information
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NPI Number | 1184107922
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Entity Type | Individual
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Provider Name | STEPHEN LEIGH JOHNSTON DNP
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Gender | Male
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Dates
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Enumeration Date | 09/07/2018
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Last Update Date | 09/07/2018
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Provider Practice Location Address
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Address Line | 1004 SUSHRUTA DR STE A
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City | MARTINSBURG
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State | WV
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Zip | 25401-8801
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Country | US
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Telephone | 304-449-3778
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Fax |
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Provider Business Mailing Address
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Address Line | 801 ENGLE SWITCH RD
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City | HARPERS FERRY
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State | WV
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Zip | 25425-5257
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Country | US
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Telephone | 304-240-7813
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN63221-FNP-BC
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License Number State | WV
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