Provider Demographics
NPI:1629598727
Name:JOHNSTON, KAYLYNN BETH (FNP-C)
Entity Type:Individual
Prefix:
First Name:KAYLYNN
Middle Name:BETH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:KAYLYNN
Other - Middle Name:BETH
Other - Last Name:FAHSHOLTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2218 N HOBART ST
Mailing Address - Street 2:
Mailing Address - City:PAMPA
Mailing Address - State:TX
Mailing Address - Zip Code:79065-3418
Mailing Address - Country:US
Mailing Address - Phone:806-665-2525
Mailing Address - Fax:806-665-2297
Practice Address - Street 1:2218 N HOBART ST
Practice Address - Street 2:
Practice Address - City:PAMPA
Practice Address - State:TX
Practice Address - Zip Code:79065-3418
Practice Address - Country:US
Practice Address - Phone:806-665-2525
Practice Address - Fax:806-665-2297
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-21
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX133931363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily