Healthcare Provider Details

I. General information

NPI: 1063533578
Provider Name (Legal Business Name): JENNIFER ANN LESTER PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 W OKLAHOMA AVE OUTPATIENT PHARMACY
MILWAUKEE WI
53215-4330
US

IV. Provider business mailing address

4745 STRATFORD DR
GREENDALE WI
53129-2016
US

V. Phone/Fax

Practice location:
  • Phone: 414-649-6930
  • Fax: 414-649-5367
Mailing address:
  • Phone: 414-235-4925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number13527-040
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: