Provider Demographics
NPI:1851421770
Name:JONES, BRENDA JEAN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:JEAN
Last Name:JONES
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20920 N SEQUOIA CV
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:IL
Mailing Address - Zip Code:61523-9328
Mailing Address - Country:US
Mailing Address - Phone:309-249-6903
Mailing Address - Fax:309-655-3072
Practice Address - Street 1:20920 N SEQUOIA CV
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:IL
Practice Address - Zip Code:61523-9328
Practice Address - Country:US
Practice Address - Phone:309-249-6903
Practice Address - Fax:309-655-3072
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist