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NPI Code Detail

MEDICARE: ANN MARIE JOHNSON RPH

MEDICARE: ANN MARIE JOHNSON RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist1138492MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11138492OTHERMNLICENSE

General Provider Information

NPI Number : 1952383465
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANN MARIE JOHNSON RPH
Provider Business Mailing Address
First Line : 16 SNOWBIRD CT
Second Line :
City : NORTH MANKATO
State : MN
Zip : 56003-1637
Country : US
Telephone Number : 507-625-8658
Fax Number :
Provider Business Practice Location Address
First Line : 600 MAYWOOD AVE
Second Line : 21 CARKOSKI COMMONS
City : MANKATO
State : MN
Zip : 56001-7008
Country : US
Telephone Number : 507-389-2483
Fax Number : 507-389-2206
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 02/09/2017

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