Provider Demographics
NPI:1023573185
Name:JOHNSTON, JAIME ANN
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ANN
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7601 MARTIN DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70126-1763
Mailing Address - Country:US
Mailing Address - Phone:504-427-2976
Mailing Address - Fax:
Practice Address - Street 1:40567 HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-5250
Practice Address - Country:US
Practice Address - Phone:225-622-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPST.02261183500000X, 1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAWMW18146871WOtherN/A
LAWMW18146871WOtherEXPRESS SCRIPTS