| NPI | 1942458864 |
|---|---|
| Former Name | JENNIFER LYNN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NC 18578) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM 6022) |
| 183500000X Pharmacist (Licence: MN 117346) | |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2010-07-28 |