Healthcare Provider Details

I. General information

NPI: 1992624316
Provider Name (Legal Business Name): MICHELLE JOHNSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 GARDEN CITY DR
HYATTSVILLE MD
20785-2418
US

IV. Provider business mailing address

4278 MEYERS RD
TRIANGLE VA
22172-1700
US

V. Phone/Fax

Practice location:
  • Phone: 571-743-2811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: