Provider Demographics
NPI:1124624333
Name:KREY, JESSICA JOAN (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JOAN
Last Name:KREY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4229 LIMESTONE DR
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2049
Mailing Address - Country:US
Mailing Address - Phone:651-353-8709
Mailing Address - Fax:
Practice Address - Street 1:7850 CAHILL AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-3057
Practice Address - Country:US
Practice Address - Phone:651-450-0676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN122961183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist