Healthcare Provider Details

I. General information

NPI: 1144398454
Provider Name (Legal Business Name): ASHLEY BROOKE JOHNSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 WOODMOOR DR STE 102
MONUMENT CO
80132-9083
US

IV. Provider business mailing address

1840 WOODMOOR DR STE 102
MONUMENT CO
80132-9083
US

V. Phone/Fax

Practice location:
  • Phone: 719-622-6522
  • Fax: 719-622-6520
Mailing address:
  • Phone: 719-622-6522
  • Fax: 719-622-6520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0061240
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: