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General NPI Number Information
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NPI Number | 1033417258
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Entity Type | Individual
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Provider Name | TERESA BRYANT JENNINGS RPH
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Gender | Female
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Dates
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Enumeration Date | 03/11/2011
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Last Update Date | 03/11/2011
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Provider Practice Location Address
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Address Line | 650 S. MAIN STREET
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City | KING
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State | NC
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Zip | 27021
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Country | US
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Telephone | 336-983-4165
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Fax | 336-983-6336
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Provider Business Mailing Address
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Address Line | P.O. BOX 715
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City | KING
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State | NC
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Zip | 27021
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Country | US
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Telephone | 336-983-4165
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Fax | 336-983-6336
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 12801
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 6377
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202007691
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License Number State | VA
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