Provider Demographics
NPI:1841022522
Name:JONES, JORDANNA M (PHARMD)
Entity type:Individual
Prefix:
First Name:JORDANNA
Middle Name:M
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JORDANNA
Other - Middle Name:
Other - Last Name:FEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:440 E TAMPA ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65806-1131
Mailing Address - Country:US
Mailing Address - Phone:417-831-0150
Mailing Address - Fax:
Practice Address - Street 1:1720 W GRAND ST STE B
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-4802
Practice Address - Country:US
Practice Address - Phone:417-831-0150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024030086183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist