Organization
KEYSTONE PRIMARY CARE LLC
Active
Other names
Keystone Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FATIMAH AISHA JOHNSON AG-NP (NP)
(303) 755-5542
Entity
Organization
Contact information
Practice address
11111 E MISSISSIPPI AVE STE 112, AURORA, CO 80012-3106
(303) 755-5542
(720) 749-2121
Mailing address
11111 E MISSISSIPPI AVE STE 112, AURORA, CO 80012-3106
(303) 755-5542
(720) 749-2121
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0993831
NP LIC
CO
01
—
1871081737
NPI
CO
01
—
653232
MEDICARE
—
Enumeration date
07/06/2020
Last updated
12/22/2023
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