Individual
TRACY JO JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
10535 PARK MEADOWS BLVD STE 102, LONE TREE, CO 80124-8456
(303) 695-6106
(303) 695-1211
Mailing address
25 CROSSROADS DR STE 306, OWINGS MILLS, MD 21117-5437
(443) 231-1681
(443) 471-8540
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0001221
CO
363AS0400X
Surgical Physician Assistant
—
CO
Other
Enumeration date
10/26/2006
Last updated
05/15/2023
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