Individual
LARA ELIZABETH JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
20603 SKY MEADOW LN, GOLDEN, CO 80401-8879
(580) 251-0082
Mailing address
4220 NW 158TH ST, EDMOND, OK 73013-5248
(580) 251-0082
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
110003747
VA
363A00000X
Physician Assistant
5737
OK
363A00000X
Physician Assistant
667
AK
363A00000X
Physician Assistant
Primary
PA0009526
CO
363A00000X
Physician Assistant
PA05335
TX
Other
Enumeration date
07/27/2006
Last updated
06/29/2026
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