Provider Demographics
NPI:1245118736
Name:FIELDS-JOHNSON, CLATONNAH L (PHARMD)
Entity type:Individual
Prefix:
First Name:CLATONNAH
Middle Name:L
Last Name:FIELDS-JOHNSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:TONNAH
Other - Middle Name:
Other - Last Name:FIELDS-JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2765 10TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33461-3185
Mailing Address - Country:US
Mailing Address - Phone:561-223-4364
Mailing Address - Fax:561-223-4358
Practice Address - Street 1:2765 10TH AVE N
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33461-3185
Practice Address - Country:US
Practice Address - Phone:561-223-4364
Practice Address - Fax:561-223-4358
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-23
Last Update Date:2025-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS69421183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist