Provider Demographics
NPI:1285453290
Name:QUEVEDO, JORDYN MICHELLE (PHARMD)
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:MICHELLE
Last Name:QUEVEDO
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 1:12965 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85739-9594
Mailing Address - Country:US
Mailing Address - Phone:520-825-7747
Mailing Address - Fax:
Practice Address - Street 1:12965 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85739-9594
Practice Address - Country:US
Practice Address - Phone:520-825-7747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS027266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist