Provider Demographics
NPI:1639227713
Name:JEWKES, NANCY LEE (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LEE
Last Name:JEWKES
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 SOUTH 100 WEST
Mailing Address - Street 2:PO BOX 62
Mailing Address - City:ORANGEVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84537
Mailing Address - Country:US
Mailing Address - Phone:435-758-2159
Mailing Address - Fax:
Practice Address - Street 1:25 WEST MAIN
Practice Address - Street 2:
Practice Address - City:CASTLE DALE
Practice Address - State:UT
Practice Address - Zip Code:84513
Practice Address - Country:US
Practice Address - Phone:435-381-5464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT264018-17011835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy