Provider Demographics
NPI:1700160231
Name:JOHNSTON, MELISSA K (FNP, PMHNP)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:K
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:FNP, PMHNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:K
Other - Last Name:BRITTICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1832
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:KS
Mailing Address - Zip Code:66762-1832
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3011 N MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:KS
Practice Address - Zip Code:66762-2546
Practice Address - Country:US
Practice Address - Phone:620-231-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-03
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR221007363LP0808X
MO2011016630363LP0808X
KS53-84257-082363LP0808X
MO2005009323163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR289129758Medicaid
MO429845902Medicaid