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Individual

MRS. CHARLOTTE REBECCA JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
C-AA

Contact information

Practice address
1400 E BOULDER ST, COLORADO SPRINGS, CO 80909-5533
(719) 365-5000
Mailing address
2695 ROCKY MOUNTAIN AVE STE 150, LOVELAND, CO 80538-9071
(970) 624-4034
(970) 490-4347

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
ANT.0000099
CO
367H00000X
Anesthesiologist Assistant
CO

Other

Enumeration date
12/27/2018
Last updated
01/07/2019
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