Provider Demographics
NPI:1245834407
Name:JOHNSON, DONNA LYN (PHARM D)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:LYN
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 1:8600 S AVENUE 5 E
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-9524
Mailing Address - Country:US
Mailing Address - Phone:775-546-3450
Mailing Address - Fax:
Practice Address - Street 1:2917 E HART STREET
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85369
Practice Address - Country:US
Practice Address - Phone:928-269-2765
Practice Address - Fax:928-269-8088
Is Sole Proprietor?:No
Enumeration Date:2020-11-27
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18918183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist