Provider Demographics
NPI:1962232934
Name:JOHNSON, CINNAMON JOHNAYE (RN)
Entity type:Individual
Prefix:
First Name:CINNAMON
Middle Name:JOHNAYE
Last Name:JOHNSON
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9825 E GIRARD AVE
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5040
Mailing Address - Country:US
Mailing Address - Phone:720-809-4476
Mailing Address - Fax:
Practice Address - Street 1:9825 E GIRARD AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5040
Practice Address - Country:US
Practice Address - Phone:720-809-4476
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-05
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1654682163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health