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General NPI Number Information
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NPI Number | 1003269028
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Entity Type | Individual
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Provider Name | DOUGLAS JOHNSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 07/14/2016
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Last Update Date | 12/02/2019
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Provider Practice Location Address
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Address Line | 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-1098
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Country | US
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Telephone | 904-655-4344
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Fax |
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Provider Business Mailing Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-1098
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Country | US
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Telephone | 619-410-9060
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ARNP9298958
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R174585
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License Number State | MD
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