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Individual
DR. STACIE N JOHNSON
Active
Individual
DR. STACIE N JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
21791
MD
207L00000X
Anesthesiology Physician
Primary
P0070
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285133901
—
TX
05
—
285133902
—
TX
01
—
8W8911
BLUE CROSS BLUE SHIELD
TX
01
—
P01095291
RAILROAD MEDICARE
TX
Enumeration date
07/13/2007
Last updated
07/13/2022
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