Individual
DONNA GRACE LAIRD JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
18624
SC
390200000X
Student in an Organized Health Care Education/Training Program
205462
SC
Other
Enumeration date
10/01/2013
Last updated
07/31/2018
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