Individual
JEREMY DUANE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9320 GRAND CORDERA PKWY STE 100, COLORADO SPRINGS, CO 80924-7004
(719) 282-6337
Mailing address
9320 GRAND CORDERA PKWY STE 100, COLORADO SPRINGS, CO 80924-7004
(719) 282-6337
(719) 282-0532
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA.0005940
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9000177362
—
CO
Enumeration date
08/30/2019
Last updated
02/18/2026
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