Provider Demographics
NPI:1548882228
Name:JONES, DAWN KELLEIGH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:KELLEIGH
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:KELLEIGH
Other - Last Name:GIVENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:17435 COUNTY ROAD 6
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-3046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17435 COUNTY ROAD 6
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-3046
Practice Address - Country:US
Practice Address - Phone:763-473-0977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122745183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist