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Individual

MARILYN JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
2401 S 31ST ST, TEMPLE, TX 76508-0001
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
(254) 724-8800

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
168534
CO
367500000X
Certified Registered Nurse Anesthetist
630364
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP112459
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
37526308
CO
Enumeration date
09/30/2006
Last updated
09/17/2020
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