Provider Demographics
NPI:1033400429
Name:JESSEE, KASSI (PHARMD)
Entity Type:Individual
Prefix:
First Name:KASSI
Middle Name:
Last Name:JESSEE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9485 HIGHWAY 805
Mailing Address - Street 2:
Mailing Address - City:JENKINS
Mailing Address - State:KY
Mailing Address - Zip Code:41537
Mailing Address - Country:US
Mailing Address - Phone:606-832-2084
Mailing Address - Fax:
Practice Address - Street 1:9485 HWY 805
Practice Address - Street 2:
Practice Address - City:JENKINS
Practice Address - State:KY
Practice Address - Zip Code:41537
Practice Address - Country:US
Practice Address - Phone:606-832-2084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY014292183500000X
VA0202208582183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist