Provider Demographics
NPI:1982980884
Name:AHMANN, JOLYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:JOLYNN
Middle Name:
Last Name:AHMANN
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 1:902 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-6441
Mailing Address - Country:US
Mailing Address - Phone:712-256-6583
Mailing Address - Fax:712-256-6584
Practice Address - Street 1:902 S 6TH ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3509
Practice Address - Country:US
Practice Address - Phone:712-256-6583
Practice Address - Fax:712-256-6584
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-24
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA196431835P2201X, 261QF0400X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
No261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)