Doctor Name: | LISA C JOHNSTON |
NPI Number: | 1043691959 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | BCO, BADO |
License Number: | |
Business Practice Address: | 7476 Old Fairground Rd Benson, NC - 275046105 |
Business Phone Number: | 9192072515 |
Business Fax Number: | 9198941335 |
Mailing Address: | 7476 Old Fairground Rd, BENSON |
State: | NC |
Postal Code: | 275046105 |
Phone Number: | 9192072515 |
Fax Number: | 9198941335 |
NPI Enumeration Date: | 06/16/2015 |
NPI Last Update Date: | 09/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |