Provider Demographics
NPI:1386286755
Name:GURNEY, JONATHAN EARL (PHARMD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:EARL
Last Name:GURNEY
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1725 UINTA WAY
Mailing Address - Street 2:
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-7534
Mailing Address - Country:US
Mailing Address - Phone:435-649-7606
Mailing Address - Fax:
Practice Address - Street 1:1725 UINTA WAY
Practice Address - Street 2:
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-7534
Practice Address - Country:US
Practice Address - Phone:435-649-7606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6869863-1701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist