Provider Demographics
NPI:1699983742
Name:SHIMMAN, JESSICA JEAN (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:JEAN
Last Name:SHIMMAN
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 GRASSER ST
Mailing Address - Street 2:
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3133
Mailing Address - Country:US
Mailing Address - Phone:419-691-5785
Mailing Address - Fax:419-824-1778
Practice Address - Street 1:5300 HARROUN RD
Practice Address - Street 2:STE #304
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-2182
Practice Address - Country:US
Practice Address - Phone:419-824-1360
Practice Address - Fax:419-824-1778
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist