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Individual

JAMES DEREK JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1924 ALCOA HWY, BOX U109, KNOXVILLE, TN 37920-1511
(865) 544-9220
Mailing address
319 ERIN DR, STE B, KNOXVILLE, TN 37919-6202
(865) 588-0880
(865) 584-3111

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
138393
TN
163W00000X
Registered Nurse
661322
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
3355
CA
367500000X
Certified Registered Nurse Anesthetist
73432
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100048703
PHP TENNCARE
TN
05
3635096
TN
01
4103867
BLUE CROSS
TN
Enumeration date
09/27/2006
Last updated
09/11/2025
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