Provider Demographics
NPI:1073891701
Name:JOHNSTON, EMMALEA ELIZABETH (NP-C)
Entity Type:Individual
Prefix:
First Name:EMMALEA
Middle Name:ELIZABETH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:EMMALEA
Other - Middle Name:ELIZABETH
Other - Last Name:GRIFFITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:600 N STATE OF FRANKLIN RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-8226
Mailing Address - Country:US
Mailing Address - Phone:423-232-5295
Mailing Address - Fax:423-232-9295
Practice Address - Street 1:600 N STATE OF FRANKLIN RD
Practice Address - Street 2:SUITE 5
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-8226
Practice Address - Country:US
Practice Address - Phone:423-232-5295
Practice Address - Fax:423-232-9295
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015811363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily