Individual
MARY LYNN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1567 48TH ST, BOULDER, CO 80303-1127
(303) 506-9439
Mailing address
1567 48TH ST, BOULDER, CO 80303-1127
(303) 506-9439
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
0094898
CO
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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