Diane Decillis Johnston, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

CNP54774 Issued in NM

Practice address

933 Bradbury Dr SE Ste 2222
Albuquerque, NM 87106-4375

Phone

(505) 365-2146

NPI assigned

Mar 10, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1236643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597795200000",
    "number": "1972744654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 TOWER AVE",
            "address_2": "SUITE 301",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061121273",
            "telephone_number": "860-714-2750",
            "fax_number": "860-714-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE STE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064375",
            "telephone_number": "505-365-2146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECILLIS JOHNSTON",
        "first_name": "DIANE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-10",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP54774",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Decanditis Lanphere and Associates LLC
• Michelle P Decanditis, OTRL
• Luciano Nolasco Decarvalho
• Amy Decesare, CCSS
• Alyce Lynn Dechant, PHYSICIAN ASSISTANT
• Lindsay E Deck, PHARMD
• Christina Decker, DPT
• Dustin Decker
• James Maxwell Decker, AUD
• Juniper Decker, LPCC

• Psychiatric/Mental Health Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Psychiatric/Mental Health Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.