Provider Demographics
NPI:1245913243
Name:YOUMANS, JAMIE KRISTIN
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:KRISTIN
Last Name:YOUMANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 N BANANA RIVER DR
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32952-5790
Mailing Address - Country:US
Mailing Address - Phone:239-601-1399
Mailing Address - Fax:
Practice Address - Street 1:785 N WICKHAM RD STE 104
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-8857
Practice Address - Country:US
Practice Address - Phone:321-567-7505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS40474183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist