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General NPI Number Information
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NPI Number | 1619785946
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Entity Type | Individual
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Provider Name | MARIAH JOHNSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 8200 CONSTANTIN BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70809-3481
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Country | US
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Telephone | 225-765-5000
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Fax | 225-374-1672
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 225-765-5000
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Fax | 225-765-9196
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PST.022127
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1835P0200X
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Taxonomy Name | Pediatric Pharmacist
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License Number | PST.022127
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PST.022127
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License Number State | LA
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