MEDICARE: MS. MARGARET E. JOHNSON CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	601565	TX
2	367500000X	Certified Registered Nurse Anesthetist	AP109869	TX
3	367500000X	Certified Registered Nurse Anesthetist	11009150	FL
4	367500000X	Certified Registered Nurse Anesthetist	APRN11009150	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8759UG	OTHER	TX	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659358844
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET E. JOHNSON CRNA

Provider Business Mailing Address
First Line	:	7255 BUTTERNUT LN
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-3934
Country	:	US
Telephone Number	:	216-255-5752
Fax Number	:	954-618-4555

Provider Business Practice Location Address
First Line	:	3231 MCMULLEN BOOTH RD
Second Line	:
City	:	SAFETY HARBOR
State	:	FL
Zip	:	34695-6607
Country	:	US
Telephone Number	:	727-725-6779
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	12/14/2021

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