Individual
JEFFREY R JOHANNSEN
Active
Individual
JEFFREY R JOHANNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R141280-4
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
033G2JO
MNBS #
MN
05
—
12694
—
MN
05
—
150582300
—
MN
01
—
1697627
AMERICA'S PPO/ARAZ #
MN
05
—
1730125816
—
MN
01
—
2001891
MEDICA #
MN
01
—
23758
NDBS #
MN
01
—
24174
LHS/BANNERHEALTH #
MN
01
—
DA9031034432
PREFERRED ONE #
MN
01
—
HP38479
HEALTHPARTNERS #
MN
Enumeration date
06/20/2006
Last updated
07/19/2012
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