Provider Demographics
NPI:1992014427
Name:WINTERS, JESSICA J (PHARM D)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:J
Last Name:WINTERS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 JOE RAMSEY BLVD E
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75401-7714
Mailing Address - Country:US
Mailing Address - Phone:903-455-2180
Mailing Address - Fax:903-454-1640
Practice Address - Street 1:3001 JOE RAMSEY BLVD E
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75401-7714
Practice Address - Country:US
Practice Address - Phone:903-455-2180
Practice Address - Fax:903-454-1640
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45835183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist