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Contact Information

LANCE M JOHNSON, CRNA
541 HISTORIC HWY 441 N
DEMOREST, GA30535
 Phone: 706-839-6205
 Fax: 706-754-9668
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

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

NPI # 1699795864
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 07/20/2006
Last updated 10/11/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • GA License # R142266
  • GA Medicaid 000819475B
  • GA Medicaid 00819475A
Hospital affiliation(s) Not Available
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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