Provider Demographics
NPI:1194129569
Name:TAYLOR-JOHNS, KAMERA RAE (APN)
Entity type:Individual
Prefix:
First Name:KAMERA
Middle Name:RAE
Last Name:TAYLOR-JOHNS
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5397 CRACKER BARREL CIR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80917-1803
Mailing Address - Country:US
Mailing Address - Phone:719-459-0662
Mailing Address - Fax:
Practice Address - Street 1:5397 CRACKER BARREL CIR
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80917-1803
Practice Address - Country:US
Practice Address - Phone:719-459-0662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-14
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0991367-NP363LA2200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO410304ZN28Medicare PIN