Individual
JUANITA SUZANNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5000
Mailing address
2101 HIGHWAY 90, GAUTIER, MS 39553-5340
(227) 497-7576
(228) 497-8869
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R856018
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00454210
—
MS
Enumeration date
12/27/2006
Last updated
08/25/2020
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