Provider Demographics
NPI:1033693817
Name:SUTTON, JENNIE JOHNSTON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIE
Middle Name:JOHNSTON
Last Name:SUTTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:MISS
Other - First Name:JENNIE
Other - Middle Name:ANN
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:204 ADMIRAL CIR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-3526
Mailing Address - Country:US
Mailing Address - Phone:931-242-1080
Mailing Address - Fax:
Practice Address - Street 1:204 ADMIRAL CIR
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-3526
Practice Address - Country:US
Practice Address - Phone:931-242-1080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist