Provider Demographics
NPI:1386841526
Name:JOHNSON, CATINA LUZINDA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CATINA
Middle Name:LUZINDA
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 1:1927 E EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-2509
Mailing Address - Country:US
Mailing Address - Phone:225-634-0590
Mailing Address - Fax:225-524-4052
Practice Address - Street 1:4052 HWY 951
Practice Address - Street 2:200 BUILDING
Practice Address - City:JACKSON
Practice Address - State:LA
Practice Address - Zip Code:70748
Practice Address - Country:US
Practice Address - Phone:225-634-0590
Practice Address - Fax:225-634-0521
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA17246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist