Provider Demographics
NPI:1760529820
Name:JOHNSON, JULIE KAY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:KAY
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 1:4354 RUSTIC PL
Mailing Address - Street 2:
Mailing Address - City:SHOREVIEW
Mailing Address - State:MN
Mailing Address - Zip Code:55126-6247
Mailing Address - Country:US
Mailing Address - Phone:651-484-6529
Mailing Address - Fax:
Practice Address - Street 1:MINNESOTA PHARMACISTS ASSOCIATION
Practice Address - Street 2:1935 WEST COUNTY ROAD B-2, SUITE 165
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113
Practice Address - Country:US
Practice Address - Phone:651-789-3204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1135835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist