IndividualActive
Calissta Johnson, PHARMD
NPI 1619543394 · Nutrition Support Pharmacist · Cedar Park, TX
Provider details
- NPI number
- 1619543394
- Entity type
- Individual
- Primary specialty
- Nutrition Support PharmacistPharmacy Service Providers
- Credential
- PHARMD
- Sex
- Female
- Sole proprietor
- Yes
- License
- 55618 (TX)
Practice location
2500 S Lakeline Blvd Ste 202
Cedar Park, TX 78613-2969
Phone: (512) 628-1090
Fax: (512) 628-1089
Mailing address
2500 S Lakeline Blvd Ste 202
Cedar Park, TX 78613-2969
Registry dates
- Enumerated
- 2021-06-02
- Last updated
- 2021-06-02
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.