Provider Demographics
NPI:1144565441
Name:JOHNSON, LORI DOBBS (CRNA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:DOBBS
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:DOBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:SUITE 435
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-2013
Mailing Address - Country:US
Mailing Address - Phone:615-385-3704
Mailing Address - Fax:615-292-1321
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:SUITE 435
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-385-3704
Practice Address - Fax:615-292-1321
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN17226367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered