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General NPI Number Information
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NPI Number | 1306909601
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Entity Type | Individual
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Provider Name | LISABETH EMERSON JOHNSTON PHD APRN
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Gender | Female
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 361 PARK ROAD
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City | WEST HARTFORD
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State | CT
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Zip | 06119
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Country | US
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Telephone | 860-523-1101
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Fax | 860-233-4305
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Provider Business Mailing Address
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Address Line | 145 WHITING LANE
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City | WEST HARTFORD
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State | CT
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Zip | 06119
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Country | US
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Telephone | 860-233-4305
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Fax | 860-233-4305
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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 | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 000355
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License Number State | CT
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