Provider Demographics
NPI:1619399730
Name:JOLLEY, MONICA REGISTER (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:REGISTER
Last Name:JOLLEY
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 1:154 MERION
Mailing Address - Street 2:
Mailing Address - City:SAINT SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2411
Mailing Address - Country:US
Mailing Address - Phone:706-474-6679
Mailing Address - Fax:
Practice Address - Street 1:154 MERION
Practice Address - Street 2:
Practice Address - City:SAINT SIMONS ISLAND
Practice Address - State:GA
Practice Address - Zip Code:31522-2411
Practice Address - Country:US
Practice Address - Phone:706-474-6679
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist