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Individual

CASEY J JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
600 S MONROE ST, ENID, OK 73701-7211
(580) 402-2261
(405) 758-5582
Mailing address
PO BOX 6112, ENID, OK 73702-6112

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
217424
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14538057
CAQH
05
201246930A
OK
Enumeration date
05/11/2006
Last updated
08/15/2025
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