Healthcare Provider Details

I. General information

NPI: 1629986542
Provider Name (Legal Business Name): JENNA YOCKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNA VEROST

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5250 VIRGINIA WAY
BRENTWOOD TN
37027-7574
US

IV. Provider business mailing address

7311 SHALLOW CREEK TRL APT B
VICTOR NY
14564-9442
US

V. Phone/Fax

Practice location:
  • Phone: 888-838-5852
  • Fax:
Mailing address:
  • Phone: 716-345-1443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number073285
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: