Provider Demographics
NPI:1083121958
Name:DAWSON, JENA CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENA
Middle Name:CHRISTINE
Last Name:DAWSON
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 1:1004 CELESTIAL ST APT C
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45202-1769
Mailing Address - Country:US
Mailing Address - Phone:513-814-4146
Mailing Address - Fax:
Practice Address - Street 1:8460 E MAIN ST
Practice Address - Street 2:
Practice Address - City:REYNOLDSBURG
Practice Address - State:OH
Practice Address - Zip Code:43068-4766
Practice Address - Country:US
Practice Address - Phone:614-552-0780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03323784183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist