Healthcare Provider Details

I. General information

NPI: 1154361202
Provider Name (Legal Business Name): LORENA JOHNSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 PARK MEADOWS DR STE 200
LONE TREE CO
80124-2744
US

IV. Provider business mailing address

8500 PARK MEADOWS DR STE 200
LONE TREE CO
80124-2744
US

V. Phone/Fax

Practice location:
  • Phone: 303-367-2225
  • Fax: 303-343-8702
Mailing address:
  • Phone: 303-367-2225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10003543A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.0002777
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: