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General NPI Number Information
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NPI Number | 1841893336
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Entity Type | Individual
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Provider Name | JESSICA OWSLEY PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/18/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1122 LOVERS LN
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City | BOWLING GREEN
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State | KY
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Zip | 42103-7199
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Country | US
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Telephone | 270-842-4844
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Fax |
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Provider Business Mailing Address
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Address Line | 1444 RIVA RIDGE AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42104-7633
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 014097
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License Number State | KY
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