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General NPI Number Information
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NPI Number | 1457551392
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Entity Type | Individual
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Provider Name | AIMEE D JOHNSON-WIRT M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 2405 RESEARCH PARKWAY
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City | COLORADO SPRINGS
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State | CO
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Zip | 80920
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Country | US
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Telephone | 719-522-1134
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Fax | 719-268-2819
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 719-463-5600
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Fax | 719-538-2990
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | DR.0055826
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License Number State | CO
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