Provider Demographics
NPI:1003198987
Name:BELK, JAN ERIN (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:JAN
Middle Name:ERIN
Last Name:BELK
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 1:1412 MILLER AVE
Mailing Address - Street 2:
Mailing Address - City:SHELBYVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46176-3135
Mailing Address - Country:US
Mailing Address - Phone:317-421-2020
Mailing Address - Fax:317-421-2023
Practice Address - Street 1:1412 MILLER AVE
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:IN
Practice Address - Zip Code:46176-3135
Practice Address - Country:US
Practice Address - Phone:317-421-2020
Practice Address - Fax:317-421-2023
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26023651A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist