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General NPI Number Information
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NPI Number | 1235515495
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Entity Type | Individual
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Provider Name | JENNIFER DAWN DUKETTE PHARM. D
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 08/10/2015
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Provider Practice Location Address
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Address Line | 7574B ORCHID DR
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City | SHAW AFB
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State | SC
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Zip | 29152-1488
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Country | US
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Telephone | 702-336-3765
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Fax |
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Provider Business Mailing Address
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Address Line | 615 BULTMAN DRIVE
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City | SUMTER
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State | SC
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Zip | 29150
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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 | 35949
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License Number State | SC
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