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General NPI Number Information
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NPI Number | 1528930740
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Entity Type | Individual
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Provider Name | JACLYN COLLIER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 09/18/2025
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 200 ABRAHAM FLEXNER WAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-2877
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Country | US
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Telephone | 502-587-4011
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Fax |
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Provider Business Mailing Address
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Address Line | 5410 N SHERMAN DR
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City | INDIANAPOLIS
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State | IN
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Zip | 46220-5581
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Country | US
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Telephone | 317-979-6061
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 26030341A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 02567
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License Number State | KY
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