Provider Demographics
NPI:1962271221
Name:JONES, AMANDA MARIE (PHARMD)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:586 OLD ROUTE 66
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-3729
Mailing Address - Country:US
Mailing Address - Phone:573-336-2180
Mailing Address - Fax:573-336-3529
Practice Address - Street 1:586 OLD ROUTE 66
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-3729
Practice Address - Country:US
Practice Address - Phone:573-336-2180
Practice Address - Fax:573-336-3529
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023046728183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist