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Individual

JEREMIAH JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
101 SIVLEY RD SW, HUNTSVILLE, AL 35801-4470
(256) 265-8246
Mailing address
429 MERRYWOOD DR, BIRMINGHAM, AL 35214-1613
(256) 366-2665

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-142856
AL

Other

Enumeration date
06/18/2021
Last updated
06/18/2021
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