Individual
MRS. LISA MARIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.PH, PHARM.D.
Contact information
Practice address
737 BROADWAY N, FARGO, ND 58102-4421
(701) 234-2416
Mailing address
737 N BROADWAY, FARGO, ND 58122-0001
(701) 234-2416
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
118045
MN
183500000X
Pharmacist
Primary
4967
ND
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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