Bouldin, Jessica Brooke

Bouldin, Jessica Brooke is an individual health care provider with primary practice located at 483 W Bockman Way , Sparta TN 38583-1832. She recently has only one registered license in Pharmacy Service Providers / Ambulatory Care, which is considered as her primary health care specialty. Bouldin, Jessica Brooke can be contacted via phone (931) 836-3230.

Contact Information

Primary practice address
483 W Bockman Way Sparta TN 38583-1832
Phone: (931) 836-3230
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Ambulatory Care 1835P2201X 44395 Tennessee

Profile Details

NPI number 1881284206
LBN Legal business name Bouldin, Jessica Brooke
Credentials PHARMD
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2021
Last updated Jan 20th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881284206 NPPES
Tennessee Other 44395 STATE OF TENNESSEE

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