Provider Demographics
NPI:1629427109
Name:JOHNSTON, ELIZABETH DABNEY PEARCE (CRNP, CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:DABNEY PEARCE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:CRNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 N CALVERT ST STE 650
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21218-6516
Mailing Address - Country:US
Mailing Address - Phone:410-554-7333
Mailing Address - Fax:410-554-7334
Practice Address - Street 1:3333 N CALVERT ST STE 650
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-6516
Practice Address - Country:US
Practice Address - Phone:410-554-7333
Practice Address - Fax:410-554-7334
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR201041363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD524428500Medicaid