Stacy Nicole Johnson PA-S

NPI 1497993703 - Physician Assistant - 363A00000X

NPI Details
NPI 1497993703
Gender Female
Enumeration Date 01/23/2009
Last Updated 11/28/2011
Entity Type Individual
Active Over 7 years ago
Practice Location
11651 W 64TH AVE
D-5
ARVADA CO, 80004-4323, US
Phone (303) 425-5536
Fax (303) 425-0769
Business Location
11651 W 64TH AVE
D-5
ARVADA CO, 80004-4323, US
Phone (303) 425-5536
Fax (303) 425-0769
Toxanomy
Taxonomy Code 363A00000X
License State Colorado
License Number 2719
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According to our database, Stacy Nicole Johnson PA-S NPI is 1497993703, taxonomy code is 363A00000X and license number is 2719, license state is located at Colorado. Stacy Nicole Johnson PA-S physically located at 11651 W 64th Ave, Arvada CO, 80004-4323. NPI Number Stacy Nicole Johnson PA-S has the Individual type.

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1497993703 NPI number is provided on an as is basis without warranty of any kind. 1497993703 is maintained by the National Plan & Provider Enumeration System. The contents of Stacy Nicole Johnson PA-S are for informational purposes only.