1801193263 NPI number — DR. ALEXANDRIA ERIN WHITT JOHNSON PHARMD

Table of content: DR. ALEXANDRIA ERIN WHITT JOHNSON PHARMD (NPI 1801193263)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801193263 NPI number — DR. ALEXANDRIA ERIN WHITT JOHNSON PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSON
Provider First Name:
ALEXANDRIA
Provider Middle Name:
ERIN WHITT
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1801193263
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 690
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEATTYVILLE
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41311-0690
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
606-464-0151
Provider Business Mailing Address Fax Number:
606-464-0152

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1484 LAKESIDE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41339-6555
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
606-666-9950
Provider Business Practice Location Address Fax Number:
606-666-9136
Provider Enumeration Date:
02/22/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  014976 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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