Provider Demographics
NPI:1508986050
Name:JOHNSON-ONESTO, JACQUELINE JEAN
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:JEAN
Last Name:JOHNSON-ONESTO
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 1:510 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-4227
Mailing Address - Country:US
Mailing Address - Phone:563-263-1852
Mailing Address - Fax:
Practice Address - Street 1:939 ANGULAR ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-3918
Practice Address - Country:US
Practice Address - Phone:319-753-0112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA18672183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist