NPI age
20 years
Enumerated 2006-05-11
● Active
Type 1 · Individual
Gary R Johanson, CRNA
Johanson is 1 of 31 nurse anesthetist, certified registered providers in Pocatello and 1 of 575 in Idaho.
Primary specialty
Nurse Anesthetist, Certified Registered
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2011-10-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 575 active nurse anesthetist, certified registered providers in Idaho.
NPI age
20 years
↑ 5 yr above median (15 yr)
State licenses
1 state
18% of peers hold multiple states
Subspecialties
1
In the 32% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-05Enumerated in NPPES
2006
2026
Where they practice
Practice location
1950 E Clark St, Suite G
Pocatello, ID 832013314
Mailing address
Po Box 4107
Pocatello, ID 832054107
Specialties
-
Nurse Anesthetist, Certified Registered Primary(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in...
-
Registered Nurse(1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 004371700 |
Practice context
Part of a multi-provider practice. 8 other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
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