Provider Demographics
NPI:1497744833
Name:JOHNSON, DEBORAH E (CRNA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:E
Other - Last Name:TURNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-793-5380
Mailing Address - Fax:325-793-5259
Practice Address - Street 1:4400 BUFFALO GAP RD
Practice Address - Street 2:SUITE 2250
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-2723
Practice Address - Country:US
Practice Address - Phone:325-793-5380
Practice Address - Fax:325-793-5259
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX029147367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86008UOtherBCBSTX
TX8G9707Medicare PIN
TX86008UOtherBCBSTX