Individual
DANIEL JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
275 W ABRIENDO AVE, PUEBLO, CO 81004-1870
(720) 987-7242
(719) 621-4974
Mailing address
135 W COKEDALE DR, PUEBLO WEST, CO 81007-1707
(719) 214-9447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN.0336297
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PN.0336297
LPN LICENSE
CO
Enumeration date
11/11/2020
Last updated
11/11/2020
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