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Individual

SAMANTHA LYNN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2526
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
288720
NC
367500000X
Certified Registered Nurse Anesthetist
6953
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
RNA243058
ME

Other

Enumeration date
06/29/2021
Last updated
10/07/2024
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