Provider Demographics
NPI:1467051961
Name:JOHNSTON, WENDI GAY (RN)
Entity Type:Individual
Prefix:
First Name:WENDI
Middle Name:GAY
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:WENDI
Other - Middle Name:TURNER
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8535 WEEPING WILLOW RD
Mailing Address - Street 2:
Mailing Address - City:BIG SANDY
Mailing Address - State:TX
Mailing Address - Zip Code:75755-5364
Mailing Address - Country:US
Mailing Address - Phone:903-576-5124
Mailing Address - Fax:
Practice Address - Street 1:8535 WEEPING WILLOW RD
Practice Address - Street 2:
Practice Address - City:BIG SANDY
Practice Address - State:TX
Practice Address - Zip Code:75755-5364
Practice Address - Country:US
Practice Address - Phone:903-576-5124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX990063163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse