Provider Demographics
NPI:1063012862
Name:STOWE, JENNIFER HUDGINS (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HUDGINS
Last Name:STOWE
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 1:1574 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-1843
Mailing Address - Country:US
Mailing Address - Phone:404-395-5906
Mailing Address - Fax:
Practice Address - Street 1:98 POWER CENTER DR
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-9431
Practice Address - Country:US
Practice Address - Phone:706-265-2484
Practice Address - Fax:706-265-2487
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA018815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist