Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mallory Quinn Johnson, RN

Individual provider Certified Registered Nurse Anesthetist · NPI 1972110815

Mallory Quinn Johnson, RN is a Certified Registered Nurse Anesthetist (CRNA) in Corbin, Kentucky. Graduated from Lincoln Memorial University Medical Department in 2020, 6 years ago. Practices with Commonwealth Anesthesia, PSC, a 178-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
6
Trained at
Lincoln Memorial University Medical Department
Licensed in
KY
In the registry since
2020
Specialties on file
2
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

449 Kelso Trl
Corbin, KY 40701-8502
Phone: (606) 273-6971
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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 3015641 (KY)
Registered Nurse Taxonomy 163W00000X · Licence 1129317 (KY)

Record details

NPI number1972110815
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorYes
NPI enumeratedSeptember 24, 2020
Last updated in NPPESJanuary 15, 2021
Certification dateJanuary 15, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolLINCOLN MEMORIAL UNIVERSITY MEDICAL DEPARTMENT
Graduated 2020 (6 years in practice)
Group practice Commonwealth Anesthesia, Psc — 178 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Corbin