Provider Demographics
NPI:1619386828
Name:ZHOU, JIE
Entity Type:Individual
Prefix:
First Name:JIE
Middle Name:
Last Name:ZHOU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4000 HYDE PARK AVE. APT 30
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4000 HYDE PARK AVE
Practice Address - Street 2:APT. 30
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-7106
Practice Address - Country:US
Practice Address - Phone:573-814-3674
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-13
Last Update Date:2014-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study