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General NPI Number Information
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NPI Number | 1689233389
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Entity Type | Individual
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Provider Name | JENNA JOHNSTON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 1650 COCHRANE CIR
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City | FORT CARSON
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State | CO
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Zip | 80913-4613
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Country | US
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Telephone | 719-524-6039
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Fax |
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Provider Business Mailing Address
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Address Line | 305 PECOS DR
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City | COLORADO SPRINGS
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State | CO
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Zip | 80911-1128
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Country | US
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Telephone |
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 21545
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License Number State | CO
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Taxonomy #2
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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 | 21545
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License Number State | CO
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