Provider Demographics
NPI:1093198558
Name:JOHNSTON, REBECCA (RN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:SILJANOVSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2200 JEFFERSON AVE
Mailing Address - Street 2:5TH FL
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43604-7101
Mailing Address - Country:US
Mailing Address - Phone:419-251-8983
Mailing Address - Fax:
Practice Address - Street 1:1 TURTLE CREEK CIR
Practice Address - Street 2:SUITE F
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-8537
Practice Address - Country:US
Practice Address - Phone:419-825-5151
Practice Address - Fax:419-825-5901
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.17335-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0141558Medicaid
OHH402730Medicare PIN