Provider Demographics
NPI:1306682307
Name:MORRIS, JESSICA (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:MORRIS
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 1:1710 AIMWELL BLVD
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:GA
Mailing Address - Zip Code:30474-9131
Mailing Address - Country:US
Mailing Address - Phone:912-585-7500
Mailing Address - Fax:
Practice Address - Street 1:980 W PARKER ST
Practice Address - Street 2:
Practice Address - City:BAXLEY
Practice Address - State:GA
Practice Address - Zip Code:31513-0653
Practice Address - Country:US
Practice Address - Phone:912-367-3234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH034913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist