Provider Demographics
NPI:1316829211
Name:JOHNSON, CINDY (PHARM D)
Entity type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:92 CAVINESS WEST RD
Mailing Address - Street 2:
Mailing Address - City:RATON
Mailing Address - State:NM
Mailing Address - Zip Code:87740-3638
Mailing Address - Country:US
Mailing Address - Phone:505-652-8122
Mailing Address - Fax:
Practice Address - Street 1:1279 S 2ND ST
Practice Address - Street 2:
Practice Address - City:RATON
Practice Address - State:NM
Practice Address - Zip Code:87740-2234
Practice Address - Country:US
Practice Address - Phone:575-245-6372
Practice Address - Fax:575-245-3291
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP6916183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist