Provider Demographics
NPI:1528185394
Name:CHATELAIN, JANE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:ANN
Last Name:CHATELAIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ANN
Other - Last Name:EMFINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:42107 DUNSON RD
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454-5143
Mailing Address - Country:US
Mailing Address - Phone:985-370-5950
Mailing Address - Fax:
Practice Address - Street 1:771 HIGHWAY 98 BYP
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-8256
Practice Address - Country:US
Practice Address - Phone:601-736-7799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST09739183500000X
LAT16894183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist