Provider Demographics
NPI:1356826101
Name:JONES, STACI LYNNE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:STACI
Middle Name:LYNNE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:STACI
Other - Middle Name:LYNNE
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5430 WHITLEY PARK TER
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-2002
Mailing Address - Country:US
Mailing Address - Phone:603-261-5174
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20899
Practice Address - Country:US
Practice Address - Phone:301-400-1974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-27
Last Update Date:2018-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist