Healthcare Provider Details

I. General information

NPI: 1720993033
Provider Name (Legal Business Name): JORDAN EVE DONOVAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9968 E GRAND RIVER AVE
BRIGHTON MI
48116-1924
US

IV. Provider business mailing address

9968 E GRAND RIVER AVE
BRIGHTON MI
48116-1924
US

V. Phone/Fax

Practice location:
  • Phone: 810-225-6200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5315269655
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302419049
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: