Individual
JEREMY C JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1301 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3171
Mailing address
1301 W MAIN ST, LAKE CITY, IA 51449-1585
(712) 464-3171
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D133437
IA
Other
Enumeration date
05/03/2013
Last updated
10/27/2016
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