Provider Demographics
NPI:1699891333
Name:JONES, PAMELA NOEL
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:NOEL
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3409 S JESSE JAMES CIR
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-7163
Mailing Address - Country:US
Mailing Address - Phone:605-371-1035
Mailing Address - Fax:
Practice Address - Street 1:1201 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-7700
Practice Address - Country:US
Practice Address - Phone:605-328-2620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD3895183500000X
MN117212-8183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist