Provider Demographics
NPI:1528349628
Name:JORGENSEN, DEBORAH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:
Last Name:JORGENSEN
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 1:11745 ROUSBY HALL RD
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-2614
Mailing Address - Country:US
Mailing Address - Phone:410-394-2730
Mailing Address - Fax:410-394-2736
Practice Address - Street 1:11745 ROUSBY HALL RD
Practice Address - Street 2:
Practice Address - City:LUSBY
Practice Address - State:MD
Practice Address - Zip Code:20657-2614
Practice Address - Country:US
Practice Address - Phone:410-394-2730
Practice Address - Fax:410-394-2736
Is Sole Proprietor?:No
Enumeration Date:2011-09-01
Last Update Date:2011-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD11939183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist