Provider Demographics
NPI:1043944978
Name:JAKOVLJEVIC, LINDSAY RENEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:RENEE
Last Name:JAKOVLJEVIC
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 1:501 S MADISON ST STE S
Mailing Address - Street 2:
Mailing Address - City:WEBB CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64870-2426
Mailing Address - Country:US
Mailing Address - Phone:417-392-6039
Mailing Address - Fax:417-392-6043
Practice Address - Street 1:501 S MADISON ST STE S
Practice Address - Street 2:
Practice Address - City:WEBB CITY
Practice Address - State:MO
Practice Address - Zip Code:64870-2426
Practice Address - Country:US
Practice Address - Phone:417-392-6039
Practice Address - Fax:417-392-6043
Is Sole Proprietor?:No
Enumeration Date:2022-07-15
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-17291183500000X
MO2015027486183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist