Provider Demographics
NPI:1043590508
Name:THORNE, JENNIFER (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:
Last Name:THORNE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 W OAKLAND AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:MN
Mailing Address - Zip Code:55912-1652
Mailing Address - Country:US
Mailing Address - Phone:507-396-0197
Mailing Address - Fax:507-396-0201
Practice Address - Street 1:1420 W OAKLAND AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:MN
Practice Address - Zip Code:55912-1652
Practice Address - Country:US
Practice Address - Phone:507-396-0197
Practice Address - Fax:507-396-0201
Is Sole Proprietor?:No
Enumeration Date:2011-08-27
Last Update Date:2011-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119999183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist