Organization
CRNA STAT INC
Active
Organization
CRNA STAT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE HARRELL JOHNSON CRNA, MS (OWNER/PROVIDER)
(312) 394-0222
Entity
Organization
Contact information
Practice address
4534 S LAKE PARK AVE, CHICAGO, IL 60653-4510
(312) 394-0222
Mailing address
4534 S LAKE PARK AVE, CHICAGO, IL 60653-4510
(312) 394-0222
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
07/08/2020
Last updated
07/24/2020
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