MEDICARE: MR. DANIEL FRANK JOHNSON

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
1	367500000X	Certified Registered Nurse Anesthetist	0001068289	VA

General Provider Information

NPI Number	:	1447240130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DANIEL FRANK JOHNSON

Provider Business Mailing Address
First Line	:	306 HARRIS GROVE LN
Second Line	:
City	:	YORKTOWN
State	:	VA
Zip	:	23692-4011
Country	:	US
Telephone Number	:	757-898-8675
Fax Number	:

Provider Business Practice Location Address
First Line	:	JEFFERSON AVE. BUILDING 576
Second Line	:
City	:	FT EUSTIS
State	:	VA
Zip	:	23604
Country	:	US
Telephone Number	:	757-314-7548
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	07/08/2007

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