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General NPI Number Information
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NPI Number | 1609969583
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Entity Type | Individual
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Provider Name | DAVID S JOHNSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4801 CLIFF AVE SUITE 101 EYE SURGERY CENTER THE CLIFFS
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City | INDEPENDENCE
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State | MO
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Zip | 64055
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Country | US
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Telephone | 816-478-4400
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Fax | 816-478-8240
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Provider Business Mailing Address
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Address Line | 4801 CLIFF AVE SUITE 100 ADMIN
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City | INDEPENDENCE
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State | MO
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Zip | 64055
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Country | US
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Telephone | 816-478-1230
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Fax | 816-350-4585
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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 | 105291
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License Number State | MO
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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 | 1492144101
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License Number State | KS
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