Provider Demographics
NPI:1659358844
Name:JOHNSON, MARGARET E (CRNA)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7255 BUTTERNUT LN
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-3934
Mailing Address - Country:US
Mailing Address - Phone:216-255-5752
Mailing Address - Fax:954-618-4555
Practice Address - Street 1:3231 MCMULLEN BOOTH RD
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6607
Practice Address - Country:US
Practice Address - Phone:727-725-6779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX601565367500000X
TXAP109869367500000X
FL11009150367500000X
FLAPRN11009150367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX003199905Medicaid
TX8759UGOtherBCBS
TX8759UGOtherBCBS
TX003199905Medicaid
TX003199903Medicaid
TX003199904Medicaid