Healthcare Provider Details

I. General information

NPI: 1033831102
Provider Name (Legal Business Name): JENNIFER MONTES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2022
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9950 BERBERICH DR
FLORENCE KY
41042-3275
US

IV. Provider business mailing address

9950 BERBERICH DR
FLORENCE KY
41042-3275
US

V. Phone/Fax

Practice location:
  • Phone: 859-372-3490
  • Fax:
Mailing address:
  • Phone: 859-638-8005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberI13890
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberI13890
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number060000431
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: