Jacqueline Joan Johnston, 112561-30

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

112561-30 Issued in WI

Practice address

N3977 Robin LN
Marinette, WI 54143-9336

Phone

(715) 735-9425

NPI assigned

Aug 18, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376784000000",
    "number": "1710310388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N3977 ROBIN LN",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541439336",
            "telephone_number": "715-735-9425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N3977 ROBIN LN",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541439336",
            "telephone_number": "715-735-9425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JACQUELINE",
        "middle_name": "JOAN",
        "credential": "112561-30",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-18",
        "last_updated": "2013-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "112561-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John P Briody MD SC
• Johnson & Valenta Family Dentistry SC
• Brian M Johnson, D.D.S. S.C.
• Karen Sue Johnson, LMT
• Dan Johnston
• Ashley Jones, FNP-C
• Shannon E. Jones, BSN-RN, NCSN
• Todd Alan Judkins, RN
• Wendy Therese Kahl, BS CSW
• Michael M Karkkainen, DO

• Registered Nurse in Marinette, WI
• Providers in Marinette, WI by specialty
• Registered Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.