Individual
JACOB WAYNE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD, RPH
Contact information
Practice address
800 ROSE ST RM H110, LEXINGTON, KY 40536-0293
(859) 323-4756
Mailing address
800 ROSE ST RM H110, LEXINGTON, KY 40536-0293
(859) 323-4756
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
025246
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2025
Last updated
08/05/2025
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