Johnson, Eileen Mary

Johnson, Eileen Mary is an individual health care provider with primary practice located at 4863 N Nevada Ave Second Floor, Colorado Springs CO 80918-3951. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Gerontology, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Johnson, Eileen Mary can be contacted via phone (719) 632-5700.

Contact Information

Primary practice address
4863 N Nevada Ave Second Floor Colorado Springs CO 80918-3951
Phone: (719) 632-5700
Fax: (719) 260-1821
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 62306 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN.0003418-NP Colorado

Profile Details

NPI number 1780741777
LBN Legal business name Johnson, Eileen Mary
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 2nd, 2007
Last updated Apr 4th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780741777 NPPES
Colorado MEDICAID 44857314
Colorado Other CO 305289

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