Individual
MR. TRAVIS WILLIAM JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
1081 N CHINA LAKE BLVD, RIDGECREST, CA 93555-3130
(760) 446-3551
Mailing address
248 N SUNLAND ST, RIDGECREST, CA 93555-3925
(760) 375-3070
(760) 499-3014
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
308421
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
2251
CA
Other
Enumeration date
07/10/2006
Last updated
09/05/2007
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