Provider Demographics
NPI:1841464419
Name:JOHNSON, ROBBI A (CRNA)
Entity type:Individual
Prefix:
First Name:ROBBI
Middle Name:A
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ROBBI
Other - Middle Name:A
Other - Last Name:STAPLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2307 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-2366
Mailing Address - Country:US
Mailing Address - Phone:402-371-0554
Mailing Address - Fax:
Practice Address - Street 1:2700 W NORFOLK AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-4438
Practice Address - Country:US
Practice Address - Phone:800-658-3901
Practice Address - Fax:402-644-7647
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE901705367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE38407OtherBCBS
NEP00806762OtherRAILROAD MEDICARE
NE099776001Medicare PIN