Provider Demographics
NPI:1811200504
Name:JOHNSTON, KATHERINE ANNE (RPH)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:ANNE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:ANNE
Other - Last Name:INGEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:10718 POTRANCO RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3312
Mailing Address - Country:US
Mailing Address - Phone:210-681-2301
Mailing Address - Fax:210-681-5736
Practice Address - Street 1:10718 POTRANCO RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3312
Practice Address - Country:US
Practice Address - Phone:210-681-2301
Practice Address - Fax:210-681-5736
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist