Provider Demographics
NPI:1427343045
Name:DEAY, JESSICA LYN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LYN
Last Name:DEAY
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 1:1801 E PARKS HWY
Mailing Address - Street 2:T-2339
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7350
Mailing Address - Country:US
Mailing Address - Phone:907-631-7201
Mailing Address - Fax:
Practice Address - Street 1:1801 E PARKS HWY
Practice Address - Street 2:T-2339
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7350
Practice Address - Country:US
Practice Address - Phone:907-631-7201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1935183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist