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General NPI Number Information
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NPI Number | 1376944702
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Entity Type | Individual
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Provider Name | NICHOLAS JOHNSTON MSN, PMHNP-BC
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Gender | Male
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Dates
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Enumeration Date | 09/04/2014
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Last Update Date | 12/02/2022
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Provider Practice Location Address
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Address Line | 269 N MAIN ST
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City | ANDOVER
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State | MA
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Zip | 01810-3008
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Country | US
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Telephone | 978-494-0175
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Fax | 978-662-5291
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Provider Business Mailing Address
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Address Line | PO BOX 1706
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City | ANDOVER
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State | MA
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Zip | 01810-0029
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Country | US
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Telephone | 978-494-0175
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Fax | 978-662-5291
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | RN2262099
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License Number State | MA
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