Individual
ALEXIS JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 REDMOND RD NW, ANESTHESIOLOGY DEPARTMENT, ROME, GA 30165-1415
(706) 291-0291
Mailing address
11541 BIRCHWOOD PIKE, HARRISON, TN 37341-7904
(423) 344-2334
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
142893
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
411025344
CHAMPUS TRICARE
GA
Enumeration date
05/31/2006
Last updated
04/30/2010
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