Provider Demographics
NPI:1114103462
Name:SKIFTON, JENNIFER JOY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JOY
Last Name:SKIFTON
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 1:191 THEATRE RD
Mailing Address - Street 2:ONALASKA CLINIC PHARMACY
Mailing Address - City:ONALASKA
Mailing Address - State:WI
Mailing Address - Zip Code:54650-8679
Mailing Address - Country:US
Mailing Address - Phone:608-392-5009
Mailing Address - Fax:608-392-5798
Practice Address - Street 1:191 THEATRE RD
Practice Address - Street 2:ONALASKA CLINIC PHARMACY
Practice Address - City:ONALASKA
Practice Address - State:WI
Practice Address - Zip Code:54650-8679
Practice Address - Country:US
Practice Address - Phone:608-392-5009
Practice Address - Fax:608-392-5798
Is Sole Proprietor?:No
Enumeration Date:2008-01-17
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN116868183500000X
WI13611-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist