Basic Information
Provider Information
NPI: 1245626936
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JOHNSTON
FirstName: HANNAH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3600 TOWER AVE
Address2:  
City: SUPERIOR
State: WI
PostalCode: 548805589
CountryCode: US
TelephoneNumber: 7153921955
FaxNumber: 7153921935
Practice Location
Address1: 3600 TOWER AVE
Address2:  
City: SUPERIOR
State: WI
PostalCode: 548805589
CountryCode: US
TelephoneNumber: 7153921955
FaxNumber: 7153921935
Other Information
ProviderEnumerationDate: 04/09/2015
LastUpdateDate: 04/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X196550-30WIY Nursing Service ProvidersRegistered Nurse 
163W00000X196251-6MNN Nursing Service ProvidersRegistered Nurse 

No ID Information.


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