Provider Demographics
NPI:1386736387
Name:PRIEST, JENNIFER E (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
Last Name:PRIEST
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:E
Other - Last Name:ROSSI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:2200 FORT ROOTS DR
Mailing Address - Street 2:119/NLR
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-1709
Mailing Address - Country:US
Mailing Address - Phone:501-257-1000
Mailing Address - Fax:501-257-2933
Practice Address - Street 1:2200 FORT ROOTS DR
Practice Address - Street 2:NLR/119
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1709
Practice Address - Country:US
Practice Address - Phone:501-257-1000
Practice Address - Fax:501-257-2933
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09937183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist