Provider Demographics
NPI:1316496748
Name:NEARY, JODY (PHARMD)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:
Last Name:NEARY
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 1:495 COBBLE DR
Mailing Address - Street 2:
Mailing Address - City:MONTROSE
Mailing Address - State:CO
Mailing Address - Zip Code:81403-8156
Mailing Address - Country:US
Mailing Address - Phone:970-240-9095
Mailing Address - Fax:
Practice Address - Street 1:495 COBBLE DR
Practice Address - Street 2:
Practice Address - City:MONTROSE
Practice Address - State:CO
Practice Address - Zip Code:81403-8156
Practice Address - Country:US
Practice Address - Phone:970-240-9095
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO16111183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist