Individual
SETH D JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-4000
(423) 224-4746
Mailing address
105 W STONE DR STE 6A, KINGSPORT, TN 37660-3256
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
187831
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
187831
TN
Other
Enumeration date
11/29/2017
Last updated
04/06/2018
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