Provider Demographics
NPI:1154361202
Name:JOHNSON, LORENA (PA)
Entity type:Individual
Prefix:MRS
First Name:LORENA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 PARK MEADOWS DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LONE TREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-2744
Mailing Address - Country:US
Mailing Address - Phone:303-367-2225
Mailing Address - Fax:
Practice Address - Street 1:8500 PARK MEADOWS DR STE 200
Practice Address - Street 2:
Practice Address - City:LONE TREE
Practice Address - State:CO
Practice Address - Zip Code:80124-2744
Practice Address - Country:US
Practice Address - Phone:303-367-2225
Practice Address - Fax:303-343-8702
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN10003543A363A00000X, 363AM0700X
COPA.0002777363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant