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KIMBERLY ANN JOHNSON FNP-BC

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1003117516

Individual Registrant:
 KIMBERLY ANN JOHNSON FNP-BC
Gender: F
Not Sole Proprietor

Location and contact information for practice:
1906 BLAKE AVE  GLENWOOD SPGS, CO 81601-4227 US
Tel: 970-384-7290  Fax: 970-384-7293

Contact information for business:
1906 BLAKE AVE  GLENWOOD SPGS, CO 81601-4227 US
Tel: 970-384-7290  Fax: 970-384-7293

Registration Information:
NPI: 1003117516
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
IL209.008453
N163W00000XNursing Service Providers
Registered Nurse
CO201184
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
CO990154

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
87336855CO05




HEALTH CARE JOBS CO - Page 1



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