Individual
MADISON GRACE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1995 TECHNOLOGY PKWY, MECHANICSBURG, PA 17050-8522
(717) 791-2600
Mailing address
2432 LOCUST ST, LATROBE, PA 15650-3324
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
RN719083
PA
367500000X
Certified Registered Nurse Anesthetist
RN719083
PA
Other
Enumeration date
10/30/2025
Last updated
01/07/2026
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