Healthcare Provider Details

I. General information

NPI: 1124329297
Provider Name (Legal Business Name): JENNY BURNS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2010
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

885 NEHALEM BLVD
WHEELER OR
97147
US

IV. Provider business mailing address

885 NEHALEM BLVD PO BOX 176
WHEELER OR
97147
US

V. Phone/Fax

Practice location:
  • Phone: 844-715-2299
  • Fax: 844-715-3299
Mailing address:
  • Phone: 844-715-2299
  • Fax: 844-715-3299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number10993
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number10993
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: