Provider Demographics
NPI:1427303254
Name:JOHNSON, ERIN LYNN CRIST (CRNA)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:LYNN CRIST
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:LYNN
Other - Last Name:CRIST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:800 CROSSRIDGE LN.
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-7506
Mailing Address - Country:US
Mailing Address - Phone:570-220-0157
Mailing Address - Fax:
Practice Address - Street 1:401 FERNDALE BLVD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-4739
Practice Address - Country:US
Practice Address - Phone:336-882-2567
Practice Address - Fax:336-882-5466
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC237507163W00000X
NC91148367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8054262Medicaid
NCQ40991AMedicare PIN