Provider Demographics
NPI:1659622181
Name:JONES, KATHERINE LEE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LEE
Last Name:JONES
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 1:3219 MYSTIC LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-1913
Mailing Address - Country:US
Mailing Address - Phone:205-657-1721
Mailing Address - Fax:
Practice Address - Street 1:3107 LURLEEN B WALLACE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3256
Practice Address - Country:US
Practice Address - Phone:205-333-9343
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL17081183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist