Individual
MR. DAMANI KOBIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1068 CRESTHAVEN RD STE 150, MEMPHIS, TN 38119-3859
(901) 412-4706
Mailing address
1068 CRESTHAVEN RD STE 150, MEMPHIS, TN 38119-3859
(901) 412-4706
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0000172873
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
0000024814
TN
Other
Enumeration date
07/18/2018
Last updated
02/21/2019
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