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General NPI Number Information
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NPI Number | 1629435797
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Entity Type | Individual
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Provider Name | JASON JOHNS CRNA
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Gender | Male
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Dates
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Enumeration Date | 01/20/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1315 HOSPITAL DRIVE PO BOX 905
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-0905
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Country | US
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Telephone | 802-748-8141
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Fax |
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Provider Business Mailing Address
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Address Line | 256 YORK ST
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City | LYNDONVILLE
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State | VT
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Zip | 05851-6105
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Country | US
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Telephone | 802-222-4502
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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 | 101.0133875
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License Number State | VT
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