Provider Demographics
NPI:1235130634
Name:DUFFIELD-JOHNSON, MEGHAN IRENE (CRNA)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:IRENE
Last Name:DUFFIELD-JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:I
Other - Last Name:KORBEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:11490 SPRINGFIELD PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45246-3524
Mailing Address - Country:US
Mailing Address - Phone:513-672-3309
Mailing Address - Fax:513-672-3323
Practice Address - Street 1:10500 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-4402
Practice Address - Country:US
Practice Address - Phone:513-672-3309
Practice Address - Fax:513-672-3323
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH274865367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2378207Medicaid
IN200416890Medicaid
OH2378207Medicaid