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Individual

ANDREW TIMOTHY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RN

Contact information

Practice address
5001 W 41ST ST, SIOUX FALLS, SD 57106-1424
(605) 362-0100
Mailing address
204 S 62ND ST, BROKEN ARROW, OK 74014-6932
(918) 932-7007

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R0117101
OK
367500000X
Certified Registered Nurse Anesthetist
Primary
212932
OK

Other

Enumeration date
04/25/2023
Last updated
11/01/2024
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