Individual
RONALD JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Mailing address
557 BROOKDALE DR, STATESVILLE, NC 28677-4107
(704) 873-5661
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
039494
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8050902
—
NC
Enumeration date
07/27/2006
Last updated
10/27/2020
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