MARY ALICE JOHNSON (CRNA) – Certified Registered Nurse Anesthetist, NPI 1417085705

MARY ALICE JOHNSON (CRNA) is a healthcare provider. based in Brookfield, Wisconsin. specializing in Certified Registered Nurse Anesthetist. They hold the professional credentials CRNA. They hold a License No. 66618-30 (WI). The NPI Number for MARY ALICE JOHNSON (CRNA) is 1417085705

Main info

Female
45 Years Of Experience
Accepts Medicare Assignment
Name
MARY ALICE JOHNSON (CRNA)
NPI
1417085705
Phone
(262) 787-4026
Address
225 S EXECUTIVE DR
Enumeration Date
1 March 2007
Last Update Date
21 July 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9204330111
Graduation Year
1981 (45 years ago)
PAC ID
3476502873
Group Practice PAC ID
4486613858
Professional Enrollment ID
I20050112000810
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

Provider Addresses for MARY ALICE JOHNSON (CRNA)

  • 225 S EXECUTIVE DR

    BROOKFIELD, WI 530054266

    Phone: (262) 787-4026

    Type: Mailing

  • 1726 SHAWANO AVE

    GREEN BAY, WI 543033216

    Phone: (920) 498-4200

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 53005)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486613858View full group profile
NameSpecialtyState
A N E S T H E S I O L O G YWI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)WI
-MI
Certified Registered Nurse Anesthetist (Crna)WI
Certified Registered Nurse Anesthetist (Crna)VA
Certified Registered Nurse Anesthetist (Crna)WI

Reviews

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Frequently asked questions

What is MARY ALICE JOHNSON (CRNA)'s NPI number?
MARY ALICE JOHNSON (CRNA)'s NPI is 1417085705 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to MARY ALICE JOHNSON (CRNA)?
You should see MARY ALICE JOHNSON (CRNA) as active in CMS-hosted NPPES data.
How would a patient describe MARY ALICE JOHNSON (CRNA)'s focus?
For MARY ALICE JOHNSON (CRNA), the primary taxonomy reads as Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What locale is associated with MARY ALICE JOHNSON (CRNA)?
Directory geography for MARY ALICE JOHNSON (CRNA) centers on Brookfield, Wisconsin.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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