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1194489898
CALLYSTA JOHNSTON
MERIDIAN, ID
NPI
1194489898
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-2118)
Enumeration Date
2021-10-28
Last Update Date
2023-06-07
Business Address
CALLYSTA JOHNSTON PA-C
4949 S HILLSDALE AVE
MERIDIAN, ID 83642-7586
Phone number: 208-706-6400
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Mailing Address
CALLYSTA JOHNSTON PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-8752
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