Individual
LAQUNNA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1810 UNION AVENUE, MEMPHIS, TN 38104-3941
(901) 272-6191
Mailing address
1810 UNION AVENUE, MEMPHIS, TN 38104-3941
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000037669
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000037669
TN LICENSE
TN
Enumeration date
12/04/2013
Last updated
12/04/2013
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