Johnson, Mat A

Johnson, Mat A is an individual health care provider with primary practice located at 1836 South Ave , La Crosse WI 54601-5429. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Johnson, Mat A can be contacted via phone (608) 782-7300.

Contact Information

Primary practice address
1836 South Ave La Crosse WI 54601-5429
Fax:
Website:

Health care specialties

Profile Details

NPI number 1508862640
LBN Legal business name Johnson, Mat A
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2005
Last updated Apr 18th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508862640 NPPES
Wisconsin MEDICAID 44304700

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