Petagaye Tm Johnson, CRNA

NPI #1205223898 in Fitchburg, Wisconsin

Provider Information

NPI Number
1205223898
Entity Type
Individual
Name
Petagaye Tm Johnson, CRNA
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Nurse Anesthetist, Certified Registered
Credential
CRNA
Enumeration Date
Apr 21, 2015
Last Updated
Apr 16, 2018

Practice Location

Address
5150 E CHERYL PKWY UNIT 301
ZIP Code
53711-7659
Phone
(786) 278-2008

Specialties & Taxonomy Codes

Specialty
Nurse Anesthetist, Certified Registered

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