Provider Demographics
NPI:1194594242
Name:ASAY, JESSICA LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:LYNN
Last Name:ASAY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LYNN
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2004 WOODED OAK LN
Mailing Address - Street 2:
Mailing Address - City:CRESTWOOD
Mailing Address - State:KY
Mailing Address - Zip Code:40014-8696
Mailing Address - Country:US
Mailing Address - Phone:502-262-1115
Mailing Address - Fax:
Practice Address - Street 1:260 LOGISTICS AVE STE B
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-4672
Practice Address - Country:US
Practice Address - Phone:800-607-6861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-29
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY017059183500000X
IN26027926A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN26027926AOtherSTATE PHARMACIST LICENSE