Healthcare Provider Details

I. General information

NPI: 1841464419
Provider Name (Legal Business Name): ROBBI A JOHNSON CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBBI A STAPLETON CRNA

II. Dates (important events)

Enumeration Date: 04/15/2008
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

IV. Provider business mailing address

2307 HIGHLAND DR
NORFOLK NE
68701-2366
US

V. Phone/Fax

Practice location:
  • Phone: 800-658-3901
  • Fax: 402-644-7647
Mailing address:
  • Phone: 402-371-0554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number901705
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: