Provider Demographics
NPI:1396166427
Name:JOHNSON, BRENN MITCHELL (CRNA)
Entity type:Individual
Prefix:
First Name:BRENN
Middle Name:MITCHELL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:CRNA
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Other - First Name:
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Mailing Address - Street 1:410 N CEDAR BLUFF RD
Mailing Address - Street 2:STE 300
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-3632
Mailing Address - Country:US
Mailing Address - Phone:865-342-8900
Mailing Address - Fax:865-691-0843
Practice Address - Street 1:161 MOUNT PELIA RD
Practice Address - Street 2:
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-3811
Practice Address - Country:US
Practice Address - Phone:731-588-0001
Practice Address - Fax:731-587-2775
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2022-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNRN173849367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered