MEDICARE: MARIA E JOHNSTON FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	RN048006	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083693444
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA E JOHNSTON FNP

Provider Business Mailing Address
First Line	:	2202 N FORBES BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85745-1412
Country	:	US
Telephone Number	:	520-746-5001
Fax Number	:	520-573-9607

Provider Business Practice Location Address
First Line	:	3939 S PARK AVE
Second Line	:	#150
City	:	TUCSON
State	:	AZ
Zip	:	85714-1635
Country	:	US
Telephone Number	:	520-746-5001
Fax Number	:	520-573-9607

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	08/15/2011

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Directions to “ MARIA E JOHNSTON FNP” Practice Location

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