Provider Demographics
NPI:1427289149
Name:JONES, ANDREA PROPHET (RPH)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:PROPHET
Last Name:JONES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:ELAINE
Other - Last Name:PROPHET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:7181 WINTHROP AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-4643
Mailing Address - Country:US
Mailing Address - Phone:225-761-3468
Mailing Address - Fax:225-761-3477
Practice Address - Street 1:7968 ESSEN PARK
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-7439
Practice Address - Country:US
Practice Address - Phone:225-761-3468
Practice Address - Fax:225-761-3477
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15306183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist