Basic Information
| Provider Information | |||||||||
| NPI: | 1578282992 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSTONE | ||||||||
| FirstName: | KRISTINA | ||||||||
| MiddleName: | KATARINA | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1155 SE CITY BEACH ST UNIT 2111 | ||||||||
| Address2: | |||||||||
| City: | OAK HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982772990 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606785151 | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | COUPEVILLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982393413 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3606785151 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2022 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2100X | AP61341751 | WA | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No ID Information.