Healthcare Provider Details

I. General information

NPI: 1174423826
Provider Name (Legal Business Name): LUCY JOHNSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2026
Last Update Date: 11/06/2026
Certification Date: 11/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 SAINT MICHAELS DR
SANTA FE NM
87505-7670
US

IV. Provider business mailing address

613 PAULIN ST
SANTA FE NM
87505-1039
US

V. Phone/Fax

Practice location:
  • Phone: 505-913-5287
  • Fax: 505-913-4949
Mailing address:
  • Phone: 719-440-8845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPC00000538
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: