Individual
JESSICA RODRIGUES JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3555 LUTHERAN PARKWAY, SUITE 340, WHEAT RIDGE, CO 80033
(303) 996-6005
(303) 420-8831
Mailing address
3555 LUTHERAN PARKWAY, SUITE 340, WHEAT RIDGE, CO 80033
(303) 996-6005
(303) 420-8831
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
3223
CO
363AM0700X
Medical Physician Assistant
Primary
3223
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
23722321
—
CO
Enumeration date
07/06/2011
Last updated
10/26/2020
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