Provider Demographics
NPI:1801485164
Name:JOHNSTON, HEATHER MARIE (RN)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARIE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 PASEO PACIFICA
Mailing Address - Street 2:
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3644
Mailing Address - Country:US
Mailing Address - Phone:530-721-1495
Mailing Address - Fax:
Practice Address - Street 1:356 PASEO PACIFICA
Practice Address - Street 2:
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3644
Practice Address - Country:US
Practice Address - Phone:530-721-1495
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-12
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN95166945163WP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP1700XNursing Service ProvidersRegistered NursePerinatal
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN95166945OtherCALIFORNIA BOARD OF NURSING