Provider Demographics
NPI:1033719927
Name:WHITE, JANA SPIVEY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANA
Middle Name:SPIVEY
Last Name:WHITE
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 1:11009 STONEHILL DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER
Mailing Address - State:AR
Mailing Address - Zip Code:72002-5003
Mailing Address - Country:US
Mailing Address - Phone:229-425-9950
Mailing Address - Fax:
Practice Address - Street 1:17309 I 30
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-2927
Practice Address - Country:US
Practice Address - Phone:501-778-5041
Practice Address - Fax:501-315-5044
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD14037183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist