Provider Demographics
NPI:1205142940
Name:JOHNSON, KEREN E (PHARM D)
Entity type:Individual
Prefix:DR
First Name:KEREN
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:KEREN
Other - Middle Name:E
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:1211 MEDICAL CENTER DR
Mailing Address - Street 2:TVC 1815
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-0004
Mailing Address - Country:US
Mailing Address - Phone:615-343-3955
Mailing Address - Fax:615-343-1977
Practice Address - Street 1:1211 MEDICAL CENTER DR
Practice Address - Street 2:TVC 1815
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0004
Practice Address - Country:US
Practice Address - Phone:615-343-3955
Practice Address - Fax:615-343-1977
Is Sole Proprietor?:No
Enumeration Date:2010-08-18
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN35464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist