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NPI Code Detail

MEDICARE: DR. JENNIFER YVETTE MAUNE PHARM.D.

MEDICARE:  DR. JENNIFER YVETTE MAUNE  PHARM.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist13619OK

General Provider Information

NPI Number : 1609097450
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JENNIFER YVETTE MAUNE PHARM.D.
Provider Business Mailing Address
First Line : 2537 NW 57TH ST
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73112-7144
Country : US
Telephone Number : 405-842-3469
Fax Number : 405-644-5129
Provider Business Practice Location Address
First Line : 4221 S WESTERN AVE
Second Line : SUITE 1045
City : OKLAHOMA CITY
State : OK
Zip : 73109-3447
Country : US
Telephone Number : 405-644-5128
Fax Number : 405-644-5129
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 07/08/2007

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Directions to “ DR. JENNIFER YVETTE MAUNE PHARM.D.” Practice Location

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