Provider Demographics
NPI:1508467697
Name:REYNOLDS, JO'NEL ELAINE (PHARMD)
Entity Type:Individual
Prefix:
First Name:JO'NEL
Middle Name:ELAINE
Last Name:REYNOLDS
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 1:13213 BRAMPTON WAY
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-6587
Mailing Address - Country:US
Mailing Address - Phone:405-808-2574
Mailing Address - Fax:
Practice Address - Street 1:4101 N MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-6239
Practice Address - Country:US
Practice Address - Phone:405-209-0363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK15187183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist