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NPI Code Detail

MEDICARE: WAYNE ANDREW JOHNSTON CRNA

MEDICARE:   WAYNE ANDREW JOHNSTON  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 Anesthetist95055CO

General Provider Information

NPI Number : 1912900127
Entity Type Code : Individual
Provider Name (Legal Business Name) : WAYNE ANDREW JOHNSTON CRNA
Provider Business Mailing Address
First Line : PO BOX 3279
Second Line :
City : DURANGO
State : CO
Zip : 81302-3279
Country : US
Telephone Number : 970-247-9606
Fax Number :
Provider Business Practice Location Address
First Line : 28 HUNTER CT
Second Line :
City : DURANGO
State : CO
Zip : 81301-7252
Country : US
Telephone Number : 970-247-9606
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 07/08/2007

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Directions to “ WAYNE ANDREW JOHNSTON CRNA” Practice Location

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