Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB JOHNSON, PHARMD
ActivePharmacist Clinician (PhC) · OCONOMOWOC, WI
Registration Details
- NPI Number
- 1629673389
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 1, 2020 (5.398476363617 yrs)
- Last Updated
- Mar 26, 2022
- License
-
20413 (WI)
Practice Information
- Address
-
1021 SUMMIT AVEOCONOMOWOC, WI, 530664499Browse WI providers · Browse ZIP 53066
- Phone
- 2625679173
- Primary Specialty
-
Pharmacist Clinician (PhC)
1835P0018X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.