Individual
BERNADETTE ANN JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10628 PARK RD, CHARLOTTE, NC 28210
(704) 667-1000
Mailing address
5025 AIRPORT CENTER PKWY BLDG L, CHARLOTTE, NC 28208-5885
(704) 512-7105
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
20245A
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8054146
—
NC
05
—
NAN041
—
SC
Enumeration date
11/10/2011
Last updated
07/24/2018
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