Provider Demographics
NPI:1952601312
Name:JOHNSTON, ALISHA LEIGH (DPM)
Entity type:Individual
Prefix:
First Name:ALISHA
Middle Name:LEIGH
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 DEMERS AVE
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-4183
Mailing Address - Country:US
Mailing Address - Phone:701-780-4085
Mailing Address - Fax:
Practice Address - Street 1:1001 7TH STREET NE
Practice Address - Street 2:
Practice Address - City:DEVILS LAKE
Practice Address - State:ND
Practice Address - Zip Code:58301-1100
Practice Address - Country:US
Practice Address - Phone:701-662-2157
Practice Address - Fax:701-662-4116
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND71213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery