Provider Demographics
NPI:1487919460
Name:CUNNINGHAM, JEAN E (PHARMD)
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:E
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:E
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-3653
Mailing Address - Country:US
Mailing Address - Phone:419-434-4391
Mailing Address - Fax:419-434-4390
Practice Address - Street 1:240 W MARKET ST
Practice Address - Street 2:
Practice Address - City:TIFFIN
Practice Address - State:OH
Practice Address - Zip Code:44883-2701
Practice Address - Country:US
Practice Address - Phone:419-447-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228053-21835P1200X
IN26022426A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy