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Contact Information

DALLEN M JOHNSON, CAA. MSA
3001 BROADMOOR BLVD NE
RIO RANCHO, NM87144-2100
 Phone: 385-278-9148
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiologist Assistant

367H00000X 32 Anesthesiology Assistant
Indicates primary specialty

NPI Profile & details for DALLEN M JOHNSON · (Male)

NPI # 1629322151
Status Active
Credentials CAA. MSA
Entity Individual
Enumeration date 11/06/2012
Last updated 12/01/2025 - About 6 months ago
Sole proprietor 1 No
Identifiers
  • IN License # 75000078A
  • NM License # AA2024-0001
Hospital affiliation(s)
  • INDIANA UNIVERSITY HEALTH - (Acute Care)
    1701 N SENATE BLVD
    INDIANAPOLIS, IN 46202
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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