Provider Demographics
NPI:1659807691
Name:HAWTHORNE, JANNA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JANNA
Middle Name:
Last Name:HAWTHORNE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MS
Other - First Name:JANNA
Other - Middle Name:
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:900 S SHACKLEFORD RD STE 501
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-3847
Mailing Address - Country:US
Mailing Address - Phone:507-228-8348
Mailing Address - Fax:
Practice Address - Street 1:900 S SHACKLEFORD RD STE 501
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3847
Practice Address - Country:US
Practice Address - Phone:507-228-8348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD132311835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist