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General NPI Number Information
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NPI Number | 1124631536
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Entity Type | Individual
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Provider Name | JESSICA FAYE CONNER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2020
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 4102 PRECISION WAY
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City | HIGH POINT
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State | NC
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Zip | 27265-8060
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Country | US
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Telephone | 336-804-6018
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Fax |
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Provider Business Mailing Address
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Address Line | 1210 HUMMINGBIRD LN
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City | SOUTH BOSTON
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State | VA
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Zip | 24592-6758
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Country | US
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Telephone | 434-222-9114
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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 | 0202219003
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License Number State | VA
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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 | 29642
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License Number State | NC
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