Individual provider · Type 1 NPI

Kathryn Mandelbaum Johnson, PA-C

Medical Physician Assistant · Boulder, CO

NPI number 1205911328 Active

Practice location

2575 Spruce St
Boulder, CO 80302-3806

Call (303) 449-3594 Map

Fax (303) 449-3112

Mailing address

345 Maxwell Ave
Boulder, CO 80304-3972

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X3470 (CO)

Medical Physician Assistant: Definition to come...

7 other providers at this address

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About NPI 1205911328

Kathryn Mandelbaum Johnson, PA-C's National Provider Identifier is 1205911328, issued on Oct 26, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boulder, CO. The record was last updated on Oct 8, 2012.