Provider Demographics
NPI:1063844355
Name:HUETT, JENNY (PHARMD)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:
Last Name:HUETT
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 1:2401 15TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35234-2833
Mailing Address - Country:US
Mailing Address - Phone:205-453-9096
Mailing Address - Fax:205-453-9097
Practice Address - Street 1:2401 15TH AVE N
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35234-2833
Practice Address - Country:US
Practice Address - Phone:205-453-9096
Practice Address - Fax:205-453-9097
Is Sole Proprietor?:No
Enumeration Date:2013-08-08
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist