Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | CNP-03238 | NM |
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | AP131970 | TX |
NPI | 1376097642 |
---|---|
Provider Name | Katherine L Johnston |
First Address | El Paso, TX 79913-0548 |
Second Address | El Paso, TX 79903-4225 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2016 |
Last Update Date | 17/03/2018 |