Healthcare Provider Details

I. General information

NPI: 1710237979
Provider Name (Legal Business Name): JENNIFER DURDEN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2012
Last Update Date: 04/07/2020
Certification Date: 04/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 SMYTH RD
MANCHESTER NH
03104-7007
US

IV. Provider business mailing address

85 WOODWARD RD
MERRIMACK NH
03054-2343
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-4366
  • Fax: 603-314-1663
Mailing address:
  • Phone: 603-475-5955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number3820
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: