MEDICARE: JENNIFER F. KINMAN 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
1	183500000X	Pharmacist	C9638	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C9638	OTHER	TN	STATE OF TN, DEPT. OF PHA

General Provider Information

NPI Number	:	1952501264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER F. KINMAN PHARM.D.

Provider Business Mailing Address
First Line	:	1543 S HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-7520
Country	:	US
Telephone Number	:	731-424-0872
Fax Number	:	731-424-6777

Provider Business Practice Location Address
First Line	:	1543 S HIGHLAND AVE
Second Line	:
City	:	JACKSON
State	:	TN
Zip	:	38301-7520
Country	:	US
Telephone Number	:	731-424-0872
Fax Number	:	731-424-6777

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/24/2007
Last Update Date	:	07/24/2007

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