MEDICARE: MRS. LORENA JOHNSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	10003543A	IN
2	363A00000X	Physician Assistant	PA.0002777	CO

General Provider Information

NPI Number	:	1154361202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORENA JOHNSON PA

Provider Business Mailing Address
First Line	:	8500 PARK MEADOWS DR STE 200
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-2744
Country	:	US
Telephone Number	:	303-367-2225
Fax Number	:

Provider Business Practice Location Address
First Line	:	8500 PARK MEADOWS DR STE 200
Second Line	:
City	:	LONE TREE
State	:	CO
Zip	:	80124-2744
Country	:	US
Telephone Number	:	303-367-2225
Fax Number	:	303-343-8702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	06/23/2025

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Directions to “ MRS. LORENA JOHNSON PA” Practice Location

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