Provider Demographics
NPI:1508155011
Name:HARMON, JAYNE ELIZABETH (RPH)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:ELIZABETH
Last Name:HARMON
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:P.O. BOX 417
Mailing Address - Street 2:
Mailing Address - City:DANIELSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30633
Mailing Address - Country:US
Mailing Address - Phone:706-424-3228
Mailing Address - Fax:
Practice Address - Street 1:380 GENERAL DANIEL AVE N
Practice Address - Street 2:
Practice Address - City:DANIELSVILLE
Practice Address - State:GU
Practice Address - Zip Code:30633
Practice Address - Country:US
Practice Address - Phone:706-795-2135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-05
Last Update Date:2011-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA014706183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist