Provider Demographics
NPI:1952563769
Name:JOHNSON, GABRIELL ANN (PHARMD)
Entity type:Individual
Prefix:
First Name:GABRIELL
Middle Name:ANN
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 1:1082 WESTBANK EXPY
Mailing Address - Street 2:
Mailing Address - City:WESTWEGO
Mailing Address - State:LA
Mailing Address - Zip Code:70094-4713
Mailing Address - Country:US
Mailing Address - Phone:504-340-4111
Mailing Address - Fax:504-349-2716
Practice Address - Street 1:1082 WESTBANK EXPY
Practice Address - Street 2:
Practice Address - City:WESTWEGO
Practice Address - State:LA
Practice Address - Zip Code:70094-4713
Practice Address - Country:US
Practice Address - Phone:504-340-4111
Practice Address - Fax:504-349-2716
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA16283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist