Provider Demographics
NPI:1972910636
Name:MONTESANO, JAMI (PHARM D)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:
Last Name:MONTESANO
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 1:4201 S NOLAND RD
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64055-7313
Mailing Address - Country:US
Mailing Address - Phone:816-478-3088
Mailing Address - Fax:816-478-1623
Practice Address - Street 1:4201 S NOLAND RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-7313
Practice Address - Country:US
Practice Address - Phone:816-478-3088
Practice Address - Fax:816-478-1623
Is Sole Proprietor?:No
Enumeration Date:2014-07-15
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013028381183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist