Provider Demographics
NPI:1235664061
Name:JOHNSON, KATHRYN LEIGH (PHARMD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LEIGH
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 CHICAGO AVE
Mailing Address - Street 2:APT 4A
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4796
Mailing Address - Country:US
Mailing Address - Phone:734-846-8523
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF KENTUCKY HEALTHCARE 800 ROSE ST RM H110
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-4796
Practice Address - Country:US
Practice Address - Phone:734-846-8523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051299526183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist