Provider Demographics
NPI:1063799088
Name:POZZA, JENNIFER DEANN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:DEANN
Last Name:POZZA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:DEANN
Other - Last Name:POZZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:JENNIFER NEELEY
Mailing Address - Street 1:1041 WOODYARD RD
Mailing Address - Street 2:
Mailing Address - City:DEFUNIAK SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:32435-4713
Mailing Address - Country:US
Mailing Address - Phone:850-974-9418
Mailing Address - Fax:
Practice Address - Street 1:2340 HIGHWAY 77
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32405-4404
Practice Address - Country:US
Practice Address - Phone:850-785-9528
Practice Address - Fax:850-532-6572
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-04
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS45653183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPS45653OtherFLORIDA DOCTORATE OF PHARMACY LICENSE NUMBER
FL258088OtherNABP E-PROFILE ID#