Provider Demographics
NPI:1558433060
Name:JOHNSTON, NICOLE BARBARA (DC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:BARBARA
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:BARBARA
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:300 CATTELL ST FL 1
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7606
Mailing Address - Country:US
Mailing Address - Phone:610-258-0252
Mailing Address - Fax:610-258-0663
Practice Address - Street 1:300 CATTELL ST FL 1
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-7606
Practice Address - Country:US
Practice Address - Phone:610-258-0252
Practice Address - Fax:610-258-0663
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor