Provider Demographics
NPI:1538311717
Name:JOHNSTON, DANIEL PAUL (PA-C)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:PAUL
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 PATTERSON ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2119
Mailing Address - Country:US
Mailing Address - Phone:615-329-0341
Mailing Address - Fax:
Practice Address - Street 1:1900 PATTERSON ST
Practice Address - Street 2:SUITE 205
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2119
Practice Address - Country:US
Practice Address - Phone:615-329-0341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-19
Last Update Date:2008-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1636363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant