Provider Demographics
NPI:1174752026
Name:JOHNSTON, KRISTIE WILLIAMS (AUD)
Entity type:Individual
Prefix:DR
First Name:KRISTIE
Middle Name:WILLIAMS
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12719 ACKLEY CIR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-0849
Mailing Address - Country:US
Mailing Address - Phone:865-671-8689
Mailing Address - Fax:
Practice Address - Street 1:2100 W CLINCH AVE STE 410
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37916-2287
Practice Address - Country:US
Practice Address - Phone:865-521-6005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000001112231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist