Provider Demographics
NPI:1225648603
Name:JONES, KRISTIE (RPH)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 WALNUT BEND DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5844
Mailing Address - Country:US
Mailing Address - Phone:817-637-9898
Mailing Address - Fax:
Practice Address - Street 1:2325 W I 20
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-3927
Practice Address - Country:US
Practice Address - Phone:972-660-1527
Practice Address - Fax:972-660-3869
Is Sole Proprietor?:No
Enumeration Date:2020-07-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37881183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist