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Individual

COLTYN TYLER JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN, CRNA

Contact information

Practice address
2525 CHICAGO AVE, MINNEAPOLIS, MN 55404-4518
(612) 813-6000
Mailing address
500 NE MULTNOMAH ST STE 100, PORTLAND, OR 97232-2031
(800) 813-2000

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
10045538
OR
367500000X
Certified Registered Nurse Anesthetist
2502
MN

Other

Enumeration date
09/09/2020
Last updated
03/16/2026
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