Johnson, Stacy Nicole

Johnson, Stacy Nicole is an individual health care provider with primary practice located at 11651 W 64Th Ave D-5, Arvada CO 80004-4323. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Johnson, Stacy Nicole can be contacted via phone (303) 425-5536.

Contact Information

Primary practice address
11651 W 64Th Ave D-5 Arvada CO 80004-4323
Phone: (303) 425-5536
Fax: (303) 425-0769
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2719 Colorado

Profile Details

NPI number 1497993703
LBN Legal business name Johnson, Stacy Nicole
Credentials PA-S
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2009
Last updated Nov 28th, 2011 - about 13 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 1497993703 NPPES
Colorado Other 2719 LICENSE

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