Individual
DR. KELLY VANESSA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM D
Contact information
Practice address
905 SNAPPS FERRY RD, GREENEVILLE, TN 37745-4026
(423) 638-8689
Mailing address
647 PLEASANT HILL RD, BULLS GAP, TN 37711-4603
(423) 638-8689
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10435
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10435
STATE LICENSE
TN
Enumeration date
03/26/2007
Last updated
07/08/2007
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