Provider Demographics
NPI:1447763214
Name:JOHNSTON, BARBARA DAWN (BS/MS)
Entity Type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:DAWN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:BS/MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2912 JASON DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27803-1614
Mailing Address - Country:US
Mailing Address - Phone:252-210-2256
Mailing Address - Fax:
Practice Address - Street 1:7369 HUNTER HILL RD
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-7954
Practice Address - Country:US
Practice Address - Phone:252-443-0867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-14
Last Update Date:2017-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP11073225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist