Healthcare Provider Details

I. General information

NPI: 1578487914
Provider Name (Legal Business Name): JESSICA HOLSOPPLE-BOWEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSICA MEGAN HOLSOPPLE PHARMD

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2799 W GRAND BLVD
DETROIT MI
48202-2608
US

IV. Provider business mailing address

216 OAKWOOD ST
YPSILANTI MI
48197-2734
US

V. Phone/Fax

Practice location:
  • Phone: 313-530-9985
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302418929
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: