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General NPI Number Information
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NPI Number | 1518917574
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Entity Type | Individual
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Provider Name | CASEY J JOHNSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 600 S MONROE ST
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City | ENID
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State | OK
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Zip | 73701-7211
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Country | US
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Telephone | 580-402-2261
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Fax | 405-758-5582
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Provider Business Mailing Address
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Address Line | PO BOX 6112
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City | ENID
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State | OK
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Zip | 73702-6112
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Country | US
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Telephone |
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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 | 217424
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License Number State | OK
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