Healthcare Provider Details

I. General information

NPI: 1659358844
Provider Name (Legal Business Name): MARGARET E. JOHNSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 12/14/2021
Certification Date: 12/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3231 MCMULLEN BOOTH RD
SAFETY HARBOR FL
34695-6607
US

IV. Provider business mailing address

7255 BUTTERNUT LN
MENTOR OH
44060-3934
US

V. Phone/Fax

Practice location:
  • Phone: 727-725-6779
  • Fax:
Mailing address:
  • Phone: 216-255-5752
  • Fax: 954-618-4555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number601565
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP109869
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11009150
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN11009150
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: