Provider Demographics
NPI:1942803440
Name:JOHNSON, ERIN CHRISTINE ENGBRING (PHARMD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CHRISTINE ENGBRING
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:CHRISTINE
Other - Last Name:ENGBRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2029 5TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-4307
Mailing Address - Country:US
Mailing Address - Phone:515-955-6453
Mailing Address - Fax:
Practice Address - Street 1:2029 5TH AVE S
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-4307
Practice Address - Country:US
Practice Address - Phone:515-955-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA23620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist