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NPI Code Detail

MEDICARE: JENNIFER CRISSON PHARMD

MEDICARE:   JENNIFER  CRISSON  PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist21073AL

General Provider Information

NPI Number : 1104465962
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER CRISSON PHARMD
Provider Business Mailing Address
First Line : 6486 KIMBERLY LOOP
Second Line :
City : PINSON
State : AL
Zip : 35126-3406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 655 FIELDSTOWN RD
Second Line :
City : GARDENDALE
State : AL
Zip : 35071-2411
Country : US
Telephone Number : 205-608-4677
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2019
Last Update Date : 12/27/2019

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Directions to “ JENNIFER CRISSON PHARMD” Practice Location

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