Most Relevant Information
Provider Data
| NPI Number: | 1003586769 |
| Provider Name: | AUDREY JOHNSON |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/15/2021 |
| Last Updated: | 09/15/2021 |
Provider Practice Location
928 12TH ST
GREELEY
CO
806314024
Practice Location Phone/Fax
| Phone: | 9703472120 |
| Fax: |
Provider Mailing Location
1300 N 17TH AVE
GREELEY
CO
806319584
Provider Mailing Phone/Fax
| Phone: | 9703472120 |
| Fax: |