Organization
RADIANT HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANJA JOHNSON NP (ADMINISTRATOR)
(541) 908-3672
Entity
Organization
Contact information
Practice address
350 ARAPAHOE AVE APT 18, BOULDER, CO 80302-5843
(541) 908-3672
Mailing address
350 ARAPAHOE AVE APT 18, BOULDER, CO 80302-5843
(541) 908-3672
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
990711
CO
Other
Enumeration date
08/31/2018
Last updated
08/31/2018
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