Individual
PETAGAYE TM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
5150 E CHERYL PKWY UNIT 301, FITCHBURG, WI 53711-7659
(786) 278-2008
Mailing address
5150 E CHERYL PKWY UNIT 301, FITCHBURG, WI 53711-7659
(786) 278-2008
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
222148
WI
Other
Enumeration date
04/21/2015
Last updated
04/16/2018
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