Individual
DARRON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
7601 SOUTHCREST PKWY, SOUTHAVEN, MS 38671-4739
(662) 772-4333
Mailing address
877 JEFFERSON AVENUE, ATTEN: PROVIDER ENROLLMENT, MEMPHIS, TN 38103
(901) 545-6286
(901) 545-8122
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
27612
TN
367500000X
Certified Registered Nurse Anesthetist
R871159
MS
Other
Enumeration date
08/10/2015
Last updated
09/08/2020
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