Individual
KEVIN W JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
616186
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002858102
—
TX
Enumeration date
10/12/2005
Last updated
03/22/2010
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