Provider Demographics
NPI:1518253517
Name:JONES, PAULA E (RPH)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:E
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 1:2100 PAUL BUNYAN DR NW
Mailing Address - Street 2:T-0657
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5645
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 PAUL BUNYAN DR NW
Practice Address - Street 2:T-0657
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5645
Practice Address - Country:US
Practice Address - Phone:218-759-0133
Practice Address - Fax:218-759-0133
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN117383183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist