Provider Demographics
NPI:1578271102
Name:JOHNSON, REBECCA ANN (ACNPC-AG)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:ACNPC-AG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8490 E CRESCENT PKWY STE 380
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-2815
Mailing Address - Country:US
Mailing Address - Phone:303-957-1310
Mailing Address - Fax:
Practice Address - Street 1:8200 E BELLEVIEW AVE STE 295E
Practice Address - Street 2:
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-2883
Practice Address - Country:US
Practice Address - Phone:303-798-0916
Practice Address - Fax:303-798-0737
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997485-NP363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology