Provider Demographics
NPI:1356864730
Name:MERRY, JOLYN NATALIE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:JOLYN
Middle Name:NATALIE
Last Name:MERRY
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:DR
Other - First Name:JOLYN
Other - Middle Name:NATALIE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARM D
Mailing Address - Street 1:5628 S 42ND STREET CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-2103
Mailing Address - Country:US
Mailing Address - Phone:402-432-2102
Mailing Address - Fax:
Practice Address - Street 1:1600 S 48TH ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-1283
Practice Address - Country:US
Practice Address - Phone:402-481-8380
Practice Address - Fax:402-481-8349
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE13884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist