Healthcare Provider Details

I. General information

NPI: 1528174240
Provider Name (Legal Business Name): JENNY REBECCA LEGGE PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3114 CROASDAILE DR
DURHAM NC
27705-2508
US

IV. Provider business mailing address

543 MEADOWOOD DR
BURLINGTON NC
27215-4679
US

V. Phone/Fax

Practice location:
  • Phone: 199-737-5409
  • Fax:
Mailing address:
  • Phone: 336-260-9548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03226375
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03226375
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: