Provider Demographics
NPI:1184408924
Name:JOHNSTON, NATHAN ERIK-JAMES (EDD)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:ERIK-JAMES
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 S CARSON AVE APT 2808
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74119-4668
Mailing Address - Country:US
Mailing Address - Phone:509-713-3942
Mailing Address - Fax:
Practice Address - Street 1:1722 S CARSON AVE APT 2808
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74119-4668
Practice Address - Country:US
Practice Address - Phone:509-713-3942
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-22
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician