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General NPI Number Information
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NPI Number | 1558475426
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Entity Type | Individual
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Provider Name | REBECCA L JOHNSTON NP
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Gender | Female
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 10/13/2011
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Provider Practice Location Address
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Address Line | 87 NORTH MAIN STREET
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-534-8701
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Fax | 978-534-8705
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Provider Business Mailing Address
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Address Line | 87 N MAIN ST
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City | LEOMINSTER
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State | MA
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Zip | 01453-5507
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Country | US
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Telephone | 978-534-8701
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Fax | 978-534-8705
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 297249
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License Number State | MA
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