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NPI Code Detail

MEDICARE: JENELLE DUSHANE PHARM D

MEDICARE:   JENELLE  DUSHANE  PHARM D
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
11835P1200XPharmacotherapy Pharmacist45021503AIN

General Provider Information

NPI Number : 1912645011
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENELLE DUSHANE PHARM D
Provider Business Mailing Address
First Line : 3600 WEST CARELTON ROAD
Second Line :
City : HILLSDALE
State : MI
Zip : 49242
Country : US
Telephone Number : 734-430-7215
Fax Number :
Provider Business Practice Location Address
First Line : 1200 LAKE CITY HWY
Second Line :
City : WARSAW
State : IN
Zip : 46580-1837
Country : US
Telephone Number : 574-371-4110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2022
Last Update Date : 05/02/2024

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Directions to “ JENELLE DUSHANE PHARM D” Practice Location

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