Provider Demographics
NPI:1700033974
Name:JOHNSON, KARI ANN (RPH)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E. VETERANS ST. 119A6 INPATIENT PHARMACY
Mailing Address - Street 2:VAMC-TOMAH
Mailing Address - City:TOMAH
Mailing Address - State:WI
Mailing Address - Zip Code:54660
Mailing Address - Country:US
Mailing Address - Phone:608-372-1685
Mailing Address - Fax:608-372-1231
Practice Address - Street 1:500 E VETERANS ST
Practice Address - Street 2:119A6 INPATIENT PHARMACY 1660-406
Practice Address - City:TOMAH
Practice Address - State:WI
Practice Address - Zip Code:54660-3105
Practice Address - Country:US
Practice Address - Phone:608-372-1685
Practice Address - Fax:608-372-1231
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4643183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist