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General NPI Number Information
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NPI Number | 1154737138
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Entity Type | Individual
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Provider Name | CHRIS JOHNSON CNA
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Gender | Male
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 536 E 1ST ST
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City | LOVELAND
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State | CO
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Zip | 80537-5718
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Country | US
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Telephone | 970-581-4394
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Fax |
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Provider Business Mailing Address
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Address Line | 536 E 1ST STEER
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City | LOVELAND
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State | CO
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Zip | 80537
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Country | US
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Telephone | 970-581-4394
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | 00758445
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License Number State | CO
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