Provider Demographics
NPI:1871743302
Name:JOHNSTON, LATONYA M (RN)
Entity type:Individual
Prefix:MISS
First Name:LATONYA
Middle Name:M
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 1:4800 STERLING CIR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-7565
Mailing Address - Country:US
Mailing Address - Phone:254-220-9255
Mailing Address - Fax:
Practice Address - Street 1:4800 STERLING CIR
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76542-7565
Practice Address - Country:US
Practice Address - Phone:254-220-9255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-20
Last Update Date:2008-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX750743163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology