Healthcare Provider Details

I. General information

NPI: 1942878020
Provider Name (Legal Business Name): LEXA MARIE JOHNSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 COUNTY ROAD 804
FRASER CO
80442-5001
US

IV. Provider business mailing address

705 MARKETPLACE PLZ STE 200 SUITE 200
STEAMBOAT SPRINGS CO
80487-1841
US

V. Phone/Fax

Practice location:
  • Phone: 970-364-2070
  • Fax: 970-879-6663
Mailing address:
  • Phone: 970-879-6663
  • Fax: 970-871-1234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRXN.0105731-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: