Provider Demographics
NPI:1093922684
Name:MONLEY, JAN M (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:M
Last Name:MONLEY
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 1:34905 CHRISTMAS LN
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-5383
Mailing Address - Country:US
Mailing Address - Phone:218-326-5062
Mailing Address - Fax:
Practice Address - Street 1:1002 COMSTOCK DR
Practice Address - Street 2:
Practice Address - City:DEER RIVER
Practice Address - State:MN
Practice Address - Zip Code:56636-9700
Practice Address - Country:US
Practice Address - Phone:218-246-3071
Practice Address - Fax:218-246-1924
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN115402183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist