Individual
JESSICA RENE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1910 W THOMAS ST, HAMMOND, LA 70401-2947
(985) 345-1600
Mailing address
1910 W THOMAS ST, HAMMOND, LA 70401-2947
(985) 345-1600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
018810
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1895750
—
LA
Enumeration date
08/24/2010
Last updated
11/03/2015
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