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General NPI Number Information
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NPI Number | 1740674894
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Entity Type | Individual
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Provider Name | DAVID K JOHNSON CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/26/2015
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 4520 MONTGOMERY BLVD NE STE 6
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1291
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Country | US
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Telephone | 505-308-3145
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Fax | 505-308-3147
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Provider Business Mailing Address
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Address Line | 4520 MONTGOMERY BLVD NE STE 6
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-1291
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Country | US
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Telephone | 505-308-3145
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Fax | 505-308-3147
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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 | 668015
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License Number State | TX
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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 | CRNA-01467
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | AP128885
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 0024184236
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License Number State | VA
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