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General NPI Number Information
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NPI Number | 1700326725
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Entity Type | Individual
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Provider Name | MICHELLE JEON PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 02/24/2017
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Last Update Date | 02/24/2017
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Provider Practice Location Address
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Address Line | 4218 LINDELL BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2916
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Country | US
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Telephone | 314-534-3829
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Fax | 314-531-1367
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Provider Business Mailing Address
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Address Line | 4218 LINDELL BLVD
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2916
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Country | US
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Telephone | 314-534-3829
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Fax | 314-531-1367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2016032032
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP449905
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License Number State | PA
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