Provider Demographics
NPI:1033325949
Name:ROBERTS, JESSICA L (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:L
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:L
Other - Last Name:VOSHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1809 ANTIOCH PIKE
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:TN
Mailing Address - Zip Code:37013-3311
Mailing Address - Country:US
Mailing Address - Phone:615-832-1585
Mailing Address - Fax:
Practice Address - Street 1:1809 ANTIOCH PIKE
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:TN
Practice Address - Zip Code:37013-3311
Practice Address - Country:US
Practice Address - Phone:615-832-1585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN23974183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist