Healthcare Provider Details

I. General information

NPI: 1033780903
Provider Name (Legal Business Name): JENNA LEA ROSE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2021
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 LAUREL ST STE 3262
DES MOINES IA
50314-3027
US

IV. Provider business mailing address

1111 6TH AVE
DES MOINES IA
50314-2611
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-4888
  • Fax: 515-643-5541
Mailing address:
  • Phone: 641-521-0387
  • Fax: 515-643-5541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number24254
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: