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NPI Code Detail

MEDICARE: ELIZABETH ANN JOHNSTON LPN

MEDICARE:   ELIZABETH ANN JOHNSTON  LPN
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
1164W00000XLicensed Practical Nurse27039913AIN

General Provider Information

NPI Number : 1215688148
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH ANN JOHNSTON LPN
Provider Business Mailing Address
First Line : 1425 W CANDLEWICK LN
Second Line :
City : WEST LAFAYETTE
State : IN
Zip : 47906-7110
Country : US
Telephone Number : 765-412-4649
Fax Number :
Provider Business Practice Location Address
First Line : 1051 CUMBERLAND AVE
Second Line :
City : WEST LAFAYETTE
State : IN
Zip : 47906-1447
Country : US
Telephone Number : 765-463-2571
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/12/2022
Last Update Date : 01/12/2022

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Directions to “ ELIZABETH ANN JOHNSTON LPN” Practice Location

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