Provider Demographics
NPI:1588983258
Name:CURTIS, JOHNNETTA CARISSA (PHARMD)
Entity type:Individual
Prefix:
First Name:JOHNNETTA
Middle Name:CARISSA
Last Name:CURTIS
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 1:8702 NATURES TRAIL CT
Mailing Address - Street 2:UNIT 202
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1624
Mailing Address - Country:US
Mailing Address - Phone:240-506-2651
Mailing Address - Fax:
Practice Address - Street 1:2635 HOUSLEY RD
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7030
Practice Address - Country:US
Practice Address - Phone:410-571-9490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-20
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15860183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist