Provider Demographics
NPI:1093977068
Name:HOKANSON, JENNIFER M (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:M
Last Name:HOKANSON
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23415 96TH AVE N
Mailing Address - Street 2:
Mailing Address - City:PORT BYRON
Mailing Address - State:IL
Mailing Address - Zip Code:61275-9718
Mailing Address - Country:US
Mailing Address - Phone:309-428-9138
Mailing Address - Fax:
Practice Address - Street 1:915 13TH AVE N
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-5067
Practice Address - Country:US
Practice Address - Phone:563-242-5944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20647183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist