Provider Demographics
NPI:1457595647
Name:JOHNSTON, VONDA K (NP)
Entity Type:Individual
Prefix:
First Name:VONDA
Middle Name:K
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:VONDA
Other - Middle Name:
Other - Last Name:REEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0388
Mailing Address - Country:US
Mailing Address - Phone:540-245-7850
Mailing Address - Fax:540-245-7854
Practice Address - Street 1:70 MEDICAL CENTER CIR STE 310
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2273
Practice Address - Country:US
Practice Address - Phone:540-245-7850
Practice Address - Fax:540-245-7854
Is Sole Proprietor?:No
Enumeration Date:2009-05-01
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024124835363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1457595647Medicaid
VA1457595647Medicaid