Individual
MR. TIMOTHY BART JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
79568 SUMNER ROAD, BROKEN BOW, NE 68822
(308) 872-2294
(308) 872-6272
Mailing address
79568 SUMNER ROAD, BROKEN BOW, NE 68822
(308) 872-2294
(308) 872-6272
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
100588
NE
Other
Enumeration date
09/22/2006
Last updated
07/08/2007
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