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General NPI Number Information
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NPI Number | 1477927358
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Entity Type | Individual
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Provider Name | JENNIFER SKYE MITCHELL RPH, PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/16/2015
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 4199 WASHINGTON ST FL 1
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City | ROSLINDALE
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State | MA
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Zip | 02131-1733
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Country | US
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Telephone | 617-323-4440
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Fax |
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Provider Business Mailing Address
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Address Line | 1089 COMMONWEALTH AVE STE 133
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City | BOSTON
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State | MA
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Zip | 02215-1041
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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 | PH60882807
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License Number State | WA
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