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General NPI Number Information
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NPI Number | 1205309309
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Entity Type | Individual
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Provider Name | BRENT HENRY JOHNSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 100 HOSPITAL DR
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City | HENDERSONVILLE
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State | NC
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Zip | 28792-5272
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Country | US
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Telephone | 828-684-8501
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Fax |
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Provider Business Mailing Address
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Address Line | 294 ROANOKE RD
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City | FLETCHER
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State | NC
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Zip | 28732-0016
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Country | US
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Telephone | 864-630-4012
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 223565
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License Number State | SC
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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 | 126127
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License Number State | SC
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