Individual
LEAH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2767 JANITELL RD, COLORADO SPRINGS, CO 80906-4102
(719) 365-2888
(719) 365-1577
Mailing address
2695 ROCKY MOUNTAIN AVE, STE 150, LOVELAND, CO 80538-9071
(970) 624-4036
(970) 490-4378
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0003878
CO
363AM0700X
Medical Physician Assistant
PA 0003878
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83083774
—
CO
Enumeration date
04/20/2012
Last updated
01/06/2021
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