Provider Demographics
NPI:1174940753
Name:JOHNSTON, KATHRYN (CNM)
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:MARIE
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:9204 N MULBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2453
Mailing Address - Country:US
Mailing Address - Phone:907-360-6119
Mailing Address - Fax:
Practice Address - Street 1:8600 NE 82ND ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64158-1430
Practice Address - Country:US
Practice Address - Phone:816-741-9122
Practice Address - Fax:816-741-9655
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1424367A00000X
MO2022015654367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife