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General NPI Number Information
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NPI Number | 1063013266
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Entity Type | Individual
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Provider Name | JENNIFER FOX PURDON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/04/2020
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Last Update Date | 11/04/2020
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Provider Practice Location Address
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Address Line | 805 US HIGHWAY 27 S
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City | CYNTHIANA
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State | KY
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Zip | 41031-6888
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Country | US
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Telephone | 859-234-3533
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Fax | 859-234-0851
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Provider Business Mailing Address
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Address Line | 106 PRINCE GEORGE DR
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City | GEORGETOWN
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State | KY
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Zip | 40324-2573
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Country | US
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Telephone |
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Fax |
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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 | 020855
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License Number State | KY
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