Brock Robert Johanson, CRNA
Brock Robert Johanson, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Stansbury Park, Utah. Qualified in 2021, 5 years ago. Practices with Northstar Anesthesia of Idaho PLLC, a 39-clinician group and accepts Medicare assignment. Licensed in Idaho.
- Years since qualifying
- 5
- Licensed in
- ID
- In the registry since
- 2021
- Specialties on file
- 2
What do these letters mean?
- CRNA — Certified Registered Nurse Anesthetist
- An advanced practice nurse who administers anaesthesia.
Practice location Address checks out
6575 Harvest LnStansbury Park, UT 84074-9063
Phone: (208) 540-1691
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Certified Registered Nurse Anesthetist (primary) | Taxonomy 367500000X · Licence 3361676 (ID) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1982289864 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | CRNA |
| Sole proprietor | No |
| NPI enumerated | March 12, 2021 |
| Last updated in NPPES | January 31, 2025 |
| Certification date | January 31, 2025 |
| Mailing address | 6575 Harvest Ln, Stansbury Park, UT 84074-9063 |
Medicare enrollment
| Medicare specialty | CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) |
|---|---|
| Medical school | OTHER |
| Graduated | 2021 (5 years in practice) |
| Group practice | Northstar Anesthesia Of Idaho Pllc — 39 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |
Other providers in Stansbury Park
-
Katlin Vanderhoef, MD
5136 N Cambridge Way, Stansbury Park, UT 84074-8279 · (801) 254-9700