Individual
RAYMOND D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
33155 ANNAPOLIS ST, WAYNE, MI 48184-2405
(734) 467-4667
(734) 467-2303
Mailing address
255 W MICHIGAN AVE, JACKSON, MI 49201-2218
(517) 787-6440
(517) 787-4146
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704182937
MI
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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