Individual
MR. MERTON OLAI JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1016 E ROOSEVELT AVE, GRANTS, NM 87020-2118
(406) 488-2295
Mailing address
1016 E ROOSEVELT, GRANTS, NM 87020
(406) 488-2295
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN010257
MT
Other
Enumeration date
01/23/2007
Last updated
02/11/2010
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