Individual
EILEEN MARY JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4863 N NEVADA AVE, SECOND FLOOR, COLORADO SPRINGS, CO 80918-3951
(719) 632-5700
(719) 260-1821
Mailing address
3205 N ACADEMY BLVD, SUITE 130, COLORADO SPRINGS, CO 80917-5101
(719) 632-5700
(719) 344-7837
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APN.0003418-NP
CO
363LG0600X
Gerontology Nurse Practitioner
62306
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44857314
—
CO
01
—
CO 305289
MEDICARE NUMBER
CO
Enumeration date
01/02/2007
Last updated
04/04/2017
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