Healthcare Provider Details

I. General information

NPI: 1295310167
Provider Name (Legal Business Name): ASHLEY L JOHNSON CPHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2021
Last Update Date: 10/28/2022
Certification Date: 03/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9334 DAYTON PIKE
SODDY DAISY TN
37379
US

IV. Provider business mailing address

9334 DAYTON PIKE
SODDY DAISY TN
37379-4855
US

V. Phone/Fax

Practice location:
  • Phone: 423-332-9957
  • Fax: 423-332-9611
Mailing address:
  • Phone: 423-332-9957
  • Fax: 423-333-9611

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number0000045247
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: