Provider Demographics
NPI:1720552672
Name:CLAYTON, JENNIFER ELIZABETH (PHARMD, BCGP)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:CLAYTON
Suffix:
Gender:F
Credentials:PHARMD, BCGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18889 161ST AVE
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-8898
Mailing Address - Country:US
Mailing Address - Phone:563-920-1135
Mailing Address - Fax:563-927-4573
Practice Address - Street 1:104 W MISSION ST
Practice Address - Street 2:
Practice Address - City:STRAWBERRY POINT
Practice Address - State:IA
Practice Address - Zip Code:52076-4400
Practice Address - Country:US
Practice Address - Phone:563-933-4762
Practice Address - Fax:563-933-9909
Is Sole Proprietor?:No
Enumeration Date:2019-01-14
Last Update Date:2019-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207531835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric