Healthcare Provider Details

I. General information

NPI: 1467980623
Provider Name (Legal Business Name): KIMBERLY JOHNSON PHARM.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6601 W INDIAN SCHOOL RD
PHOENIX AZ
85033-3339
US

IV. Provider business mailing address

7930 W MEDLOCK DR
GLENDALE AZ
85303-5565
US

V. Phone/Fax

Practice location:
  • Phone: 623-846-1533
  • Fax: 623-846-6403
Mailing address:
  • Phone: 623-846-1533
  • Fax: 623-846-6403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberS024414
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: