Provider Demographics
NPI:1528865144
Name:JOHNSON, KALIN LEIGH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KALIN
Middle Name:LEIGH
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 1:12654 READ ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68142-1796
Mailing Address - Country:US
Mailing Address - Phone:785-633-4059
Mailing Address - Fax:
Practice Address - Street 1:12654 READ ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68142-1796
Practice Address - Country:US
Practice Address - Phone:785-633-4059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-01
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X, 171400000X
NE13951183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator
No183500000XPharmacy Service ProvidersPharmacist