Provider Demographics
NPI:1346915238
Name:JOHNSON, JASMINE MARIE (PHARM D)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:MARIE
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6517 DEAN ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-1839
Mailing Address - Country:US
Mailing Address - Phone:412-961-2767
Mailing Address - Fax:
Practice Address - Street 1:331 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15221-2133
Practice Address - Country:US
Practice Address - Phone:412-961-2767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP455943183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist