Healthcare Provider Details

I. General information

NPI: 1831647437
Provider Name (Legal Business Name): SAMANTHA JOHNSON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2016
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5335 W 48TH AVE STE 500
DENVER CO
80212-2732
US

IV. Provider business mailing address

5335 W 48TH AVE STE 500
DENVER CO
80212-2732
US

V. Phone/Fax

Practice location:
  • Phone: 303-351-2173
  • Fax: 855-702-2528
Mailing address:
  • Phone: 303-351-2173
  • Fax: 855-702-2528

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPN.0995925-NP
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3010701
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN.0995925-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: