Individual
ELIZABETH A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1108 ROSS CLARK CIR, DOTHAN, AL 36301-3022
(334) 793-8087
(334) 793-8191
Mailing address
PO BOX 1928, DOTHAN, AL 36302-1928
(334) 793-8087
(331) 793-8191
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-095161
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312021000
—
FL
01
—
51533328
BCBS OF AL
AL
Enumeration date
05/04/2006
Last updated
08/07/2008
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