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NPI Code Detail

MEDICARE: KEVIN W JOHNSON CRNA

MEDICARE: KEVIN W JOHNSON CRNA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist616186TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1407844483
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN W JOHNSON CRNA
Provider Business Mailing Address
First Line : 301 UNIVERSITY BLVD
Second Line :
City : GALVESTON
State : TX
Zip : 77555-5302
Country : US
Telephone Number : 409-772-2222
Fax Number :
Provider Business Practice Location Address
First Line : 301 UNIVERSITY BLVD
Second Line :
City : GALVESTON
State : TX
Zip : 77555-5302
Country : US
Telephone Number : 409-772-2222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 03/22/2010

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