Provider Demographics
NPI:1104174291
Name:JONES, JESSICA ADAIR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ADAIR
Last Name:JONES
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 1:1017 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA
Mailing Address - State:MN
Mailing Address - Zip Code:55792-3452
Mailing Address - Country:US
Mailing Address - Phone:218-290-4919
Mailing Address - Fax:
Practice Address - Street 1:7900 32ND ST N
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:MN
Practice Address - Zip Code:55128-4054
Practice Address - Country:US
Practice Address - Phone:651-855-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN120952183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist