Provider Demographics
NPI:1528300522
Name:DARNELL, JILL A (RPH)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:A
Last Name:DARNELL
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 HONEY LOCUST LN
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-4177
Mailing Address - Country:US
Mailing Address - Phone:904-686-1098
Mailing Address - Fax:
Practice Address - Street 1:290 SOLANA RD
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-2234
Practice Address - Country:US
Practice Address - Phone:904-543-8678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS36716183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist