MEDICARE: C JOHNSON ANESTHESIA SOLUTIONS

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

General Provider Information

NPI Number	:	1639882194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C JOHNSON ANESTHESIA SOLUTIONS

Provider Business Mailing Address
First Line	:	14253 W WEST WIND DR
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85387-7017
Country	:	US
Telephone Number	:	443-846-6392
Fax Number	:

Provider Business Practice Location Address
First Line	:	14253 W WEST WIND DR
Second Line	:
City	:	SURPRISE
State	:	AZ
Zip	:	85387-7017
Country	:	US
Telephone Number	:	443-846-6392
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER MICHAEL JOHNSON
Credential	:	CRNA
Telephone Number	:	443-846-6392

Provider Enumeration Date	:	12/29/2022
Last Update Date	:	01/23/2023

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