Johnson, Colleen Maroney

Johnson, Colleen Maroney is an individual health care provider with primary practice located at 8600 75Th St Ste 101 , Kenosha WI 53142-8200. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Johnson, Colleen Maroney can be contacted via phone (262) 652-9430.

Contact Information

Primary practice address
8600 75Th St Ste 101 Kenosha WI 53142-8200
Fax: (262) 652-9433
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 60072-20 Wisconsin

Profile Details

NPI number 1013216308
LBN Legal business name Johnson, Colleen Maroney
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 25th, 2011
Last updated Apr 20th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013216308 NPPES
Wisconsin MEDICAID 1013216308

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