Individual
JEREMY D JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2341 MCCALLIE AVE, SUITE 402, CHATTANOOGA, TN 37404-3239
(423) 698-3309
(423) 624-6355
Mailing address
PO BOX 3549, CHATTANOOGA, TN 37404-0549
(423) 698-3309
(423) 624-6355
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN11982
TN
367500000X
Certified Registered Nurse Anesthetist
RN149603
GA
367500000X
Certified Registered Nurse Anesthetist
RN152219
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3636527
—
TN
01
—
4122232
BCBS
TN
01
—
P00329550
RAILROAD MEDICARE
—
Enumeration date
05/16/2006
Last updated
03/27/2019
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