Provider Demographics
NPI:1942878020
Name:JOHNSON, LEXA MARIE (FNP-C)
Entity Type:Individual
Prefix:
First Name:LEXA
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:705 MARKETPLACE PLZ STE 200
Mailing Address - Street 2:
Mailing Address - City:STEAMBOAT SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80487-1841
Mailing Address - Country:US
Mailing Address - Phone:970-879-6663
Mailing Address - Fax:970-871-1234
Practice Address - Street 1:45 COUNTY ROAD 804
Practice Address - Street 2:
Practice Address - City:FRASER
Practice Address - State:CO
Practice Address - Zip Code:80442-5001
Practice Address - Country:US
Practice Address - Phone:970-364-2070
Practice Address - Fax:970-879-6663
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-15
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0996451-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
E06210015OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
F02210037OtherAMERICAN ACADEMY OF NURSE PRACTITIONERS
COAPN.0996451-NPOtherSTATE OF COLORADO