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Individual

MRS. LESA RENEE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
101 HOSPITAL CIR, LUVERNE, AL 36049-7329
(334) 335-1172
Mailing address
567 W 6TH ST, LUVERNE, AL 36049-1649
(334) 335-5334

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
077313
AL
367500000X
Certified Registered Nurse Anesthetist
Primary
1-077282
AL

Other

Enumeration date
01/24/2007
Last updated
04/23/2019
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